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Ways to Pay for Assisted Living

 Medicaid - Private Pay - Long-Term Care Insurance

What does assisted living cost?


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In 2016, the average monthly cost of assisted living nationwide is $3,628. Alzheimer's and dementia care in assisted living costs, on average, an additional $1,150 per month, or $5,100 per month. Costs vary dramatically from state to state. In the South and Mid-West, the average monthly costs are from $3,000 - $3,600.

The average cost of assisted living in Texas as of 2016 is $3,515 / month, which is slightly under the national average of $3,600 / month. The areas of Texas with the most expensive assisted living include Amarillo, Austin, Odessa, Victoria and San Antonio, where the monthly cost averages between $4,000 - $4,600. 

Since baby boomers with aging parents may find it difficult to care for their own family, work, and assist their elderly parents, being able to pay for assisted living ensures individuals that their loved ones are being taken care of on a continuing basis.

Paying for Assisted Living

For average Americans, assisted living fees are most frequently paid out-of-pocket. Families typically use a combination of Social Security, Veterans and other pensions as well as their savings. Another common approach is to use their home’s value either through a rental, a sale or a reverse mortgage to pay for assisted living (though a reverse mortgage will require one spouse to remain in the home).

A small number of families are fortunate enough to have long term care insurance, perhaps 5% of American seniors. These individuals use those financial benefits to help with the cost of assisted living.

Medicare and Assisted Living

Medicare does not pay for assisted living, room and board, or personal care. However, medical expenses incurred at an assisted living residence may be covered by Medicare just as they would if the medical procedures occurred in a doctor’s office, hospital or at one’s home.

Medicaid and Assisted Living

Medicaid can be used to pay for long-term nursing home care in all states.
Many states also allow their residents to use Medicaid waivers to pay for assisted living or in-home care if the services can be obtained at a lower cost. Each state has individual rules, regulations and eligibility requirements.

Assisted living facilities provide food, personal care services like help with bathing or dressing, and medication administration. Historically, Medicaid did not pay for assisted living facilities.

However, Texas has two programs that offer Medicaid payment for assisted living facilities, if you meet specific criteria. If you are otherwise eligible for Medicaid and if you can show that a nursing home is medically necessary for you (also called “meeting the nursing home level of care”), then you may qualify for Community Based Alternative (CBA) Medicaid or for STAR PLUS Medicaid Waiver services. Both programs pay for home and community based services, including assisted living facilities, for people who would otherwise have to be institutionalized in a nursing home. CBA and STAR PLUS have limited enrollment and are not available in all parts of the state. For more information, contact your local Texas Department of Aging and Disability Services office.

Texas has a particular kind of assisted living facility called a continuing care facility (CCF). CCFs provide custodial care through round-the-clock supervision, but not round-the-clock nursing care. CCFs are not covered by Medicaid.


Financial Assistance for Assisted Living

Excluding Medicaid options, it is beneficial to think of financial assistance for assisted living coming in three forms:

  • The first form includes non-Medicaid federal and state programs that offer financial assistance.
  • The second form includes options or tactics that reduce the cost of living and care for the senior or their family so that those additional funds can be allocated to an assisted living residence.
  • The third form involves the liquidation or conversion of other assets so those resources can be applied towards the cost of care.
Developing a Financial Plan


Since many families pay for assisted living from their savings, they are in a state of continuously diminishing resources. Many assistance programs determine eligibility based on an individual’s resources. Therefore, the assistance available to an individual is constantly changing. In other words, usually the longer a person resides (or is projected to reside) in assisted living, the more assistance that becomes available to them.

For this reason (and others), it is advantageous to develop a long-term financial plan when considering assisted living. Doing so has the dual benefit of ensuring a comfortable and consistent aging process for your loved one while at the same time maximizing your family’s assets and resources.

The creation of financial plan for assisted living is a complicated process and one that must accommodate various health scenarios.

Fortunately, there are resources available to help families with financial planning for assisted living and each has its pros and cons.

Public Benefits Counselors – local agencies such as The Texas Area Agencies on Aging and Aging and Disability Resource Centers have benefits counselors on staff that often can help with financial planning.

While they typically do not charge for their assistance, they are often under-staffed and unable to provide adequate long term planning. They also tend to be very well-versed in local programs but may not have larger financial planning experience.

Geriatric Care Managers (GCMs) help families create and implement long term care plans and as a part of that some will help with the financial side. Since GCMs are typically paid for out-of-pocket, one can expect a higher level of attention than one might receive from a public benefits counselor.

Families tend to contact Geriatric Care Managers only after the need for care has become apparent and therefore GCMs are not in the best position to do long term planning. Often GCMs come from nursing or public health backgrounds and do not have extension financial experience.

Eldercare Financial Planners – Financial planners have the highest level of professional experience and are the most expensive option. They are very knowledgeable with long term planning but may be less aware of local programs and short term options.

Source: www.payingforseniorcare.com

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