Funding Senior Living with Medicaid
What is Medicaid (Title 19)?
Medicaid (Title 19) provides medically necessary healthcare coverage for financially needy elderly people, parents with children, people with disabilities and pregnant women. The goal is for members to live healthy, self-sufficient lives.
Medicaid can help to cover the cost of assisted living including memory care. Since Medicaid is both a federal and state program, the eligibility requirements, available programs and benefits vary.
What are the requirements to receive Medicaid Title 19?
In all states, Medicaid provides coverage for some low-income people, like the ones listed above. In some states, Medicaid has been expanded to cover all adults below a certain income level.
In order to qualify for this benefit program in the state of Iowa, you must be a resident of the state of Iowa, a U.S. national, citizen or permanent resident in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.
You can view the household size to income chart to see if you and your family could qualify. You can also fill out an online questionnaire to get a better idea of whether or not you would qualify.
What does Medicaid (Title 19) cover?
Medicaid covers a comprehensive range of healthcare services for Iowans who meet the program’s eligibility criteria. These services can include healthcare, behavioral care, long term care, home and community based support services.
For a comprehensive list of what Medicaid can cover visit Iowa’s Department of Human Services Medicare Services webpage.
What is an Elderly Waiver?
The Iowa Home and Community Based Services (HCBS) Elderly Medicaid waiver provides services and support to help the elderly who are medically qualified for nursing home care. It is designed to allow individuals to remain living at home, or in retirement communities, and receive care in those locations instead of in nursing homes.
What are the requirements to receive an Elderly Waiver?
Some of the requirements you need to meet in order to receive an Elderly Waiver in Iowa include:
Being an Iowa and U.S. resident
Being 65+ years old
You have to be determined eligible for Medicaid (Title 19) as if the member was in a medical institution. Members may be Medicaid-eligible before accessing waiver services or be determined eligible through the application process for the waiver program. Additional opportunities to access Medicaid may be available through the waiver program even if the member has previously been determined ineligible.
Be determined by the Iowa Medicaid Enterprise, Medical Services Unit, to need nursing or skilled level of care.
Does Summit Pointe Accept Medicaid (Title 19) or Elderly Waiver?
Summit Pointe is a 100% private pay community. A great resource to find out more on the Elderly Waiver Program is Heritage Area Agency on Aging 1-800-332-5934 or www.heritageaaa.org.
What is 100% private pay?
Private assisted living includes homes or facilities that are privately owned rather than affiliated with a hospital or another medical organization. They are geared towards seniors who may no longer be able to live at home, but do not need the level of medical attention offered at, for example, a nursing home. It’s important to know that Medicare typically does not pay for assisted living. Medicaid coverage is also highly unlikely, although it depends on individual state regulations.
What local communities accept Medicaid?
There are many online resources that list retirement communities that accept Medicaid. Try visiting agingresources.com for more information, assistance and resources on senior living and Medicaid coverage.