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How Do Medicaid and Long-Term Care Relate?

November 16, 2022

Government assistance programs are a common option for people looking for healthcare coverage, especially over the age of 65. However, while Medicare covers a lot, even covering emergency hospital visits at no cost, it doesn’t cover long-term care. Medicaid, a needs-based healthcare program for persons of all ages, covers the cost of long-term care for seniors and disabled individuals who meet their state’s eligibility requirements.

A wide variety of long-term care benefits may be covered based on the state and the Medicaid program for which one is applying. While nursing home care is available, there are many home and community-based services that might also be an option.

Medicaid long-term care can be provided in several settings. While originally only available to Medicaid recipients in an institutional setting, such as a nursing home, Medicaid has since expanded the locations in which one can live and receive long-term services and support. Based on the state, assistance may be provided in one’s home, the home of a close friend or relative, an adult foster care home, an assisted living facility, or in memory care (Alzheimer’s special care unit). While Medicaid may cover the cost of long-term services and supports in an adult foster care home or an assisted living residence, Medicaid will not pay the room and board portion.

Healthcare costs are increasing each year, long-term care costs included. Americans spend billions of dollars a year on various services. How people pay for long-term care depends on their financial situation and the kinds of services they use. Often, they rely on a variety of payment sources, including personal funds, pensions, savings, and income from stocks, or government assistance programs such as Medicaid, private financing options, such as long-term care insurance, veterans’ benefits, or services through the Older Americans Act.


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