Assisted living is a great option for seniors who need extra help performing daily activities, but want to retain some independence. These communities offer a variety of services and amenities, and have staff available to help residents when they need it. Medicare will not cover the costs of living in an assisted living community, but there are some other financial assistance options that can help towards payment.
Contact Bently Assisted Living at Branchville to learn more about our assisted living community.
What is Assisted Living?
Assisted living is for people who need some assistance with daily tasks, but do not require the same level of help provided by a nursing home. Assisted living facilities range in size from as few as 25 residents to 120 or more. Typically, different levels of care are offered at different price points.
Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and on-site staff; and social and recreational activities. The exact arrangements will vary from state to state.
Paying for Assisted Living
Most people are surprised to learn that Medicare does not cover assisted living. Medicare can still cover some of the necessary medical requirements of seniors who live in an assisted living community, but will not cover the cost of living in an assisted living community. There are several alternative financial assistance options for assisted living, but keep in mind that not all of these options are accessible to all people.
Medicaid is a joint federal and state program that provides health insurance to low-income Americans, including millions of elderly adults. Each state governs its own Medicaid program within federal guidelines, meaning there is some variation in eligibility and coverage depending on where you live. While Medicaid typically does not cover 100% of assisted living costs, it does help cover some portion of the expenses of assisted living.
If a state’s standard Medicaid program doesn’t cover assisted living services, there may be a Medicaid waiver program that does. Medicaid waivers are programs that expand Medicaid coverage to additional products, services, and care that are not part of the original program. Home & Community-Based Services (HCBS) waivers expand coverage to enable seniors to receive long-term care in their preferred environment instead of having to default to a nursing home due to costs.
Veterans and spouses of veterans may qualify for aid from the Department of Veterans Affairs (VA). The VA does not directly pay for the veteran’s room and board, instead, it offers financial benefits that recipients can use to cover some of the costs of living in an assisted living facility. The most relevant program is the Aid & Attendance (A&A) benefit. A&A is a monthly, needs-based payment that some veterans receive in addition to their standard VA pension.
To be eligible for A&A benefits, a veteran must meet at least one of these criteria:
- Need assistance with activities of daily living (ADL) such as bathing, dressing, eating, or adjusting prosthetic devices.
- Be bedridden.
- Reside in a nursing home due to mental or physical impairment.
- Have severe visual impairment, with a correction of 5/200 or less in both eyes or concentric contraction of the visual field to 5 degrees or less.
Benefits and Drawbacks of Assisted Living
Benefits of Assisted Living Communities
Independence: Residents are able to live as independently as they want and will still have access to the assisted living staff. Even if a senior needs daily assistance, they will still be able to retain independence in other activities that they can perform on their own.
Emergency Support: Assisted living communities do not provide regular, high-level medical care. However, staff is always on-site to assist residents in the event of an emergency, including medical emergencies.
Socialization: Living alone in their own residence can become an isolating experience for seniors. In an assisted living community, seniors are provided the chance to make new relationships and form bonds with other people. Many assisted living communities offer regular, organized group activities, wellness and exercise programs, as well as on-site libraries and chapels, where seniors can bond over common interests.
Possible Drawbacks of Assisted Living Communities
Cost: Unlike nursing homes, the cost of living in an assisted living community is not covered by Medicare. While there are other financial assistance options, the cost of assisted living communities may be prohibitive for some seniors and their families due to the lack of Medicare coverage. Nursing homes and, sometimes, in-home care are covered by Medicare.
Level of Care: If a senior has more severe or extensive medical needs, an assisted living facility may prove to be insufficient in terms of the services offered. Some people will be better suited for a nursing home or dedicated memory care facility if they are very ill, have greatly reduced mobility, or have dementia.
Change in Environment: Although assisted living communities provide a level of independence, they are still semi-communal residencies with other people living close by who will be using some of the same facilities. For those who are used to living alone or with very few people, assisted living communities can be a big adjustment.