Can I Use Medicaid to Pay for Assisted Living?

Can I Use Medicaid to Pay for Assisted Living?There are many programs available to New York Medicaid beneficiaries who need the kind of care provided by assisted living facilities. In New York, assisted living facilities that accept Medicaid residents are known as Assisted Living Programs (ALPs) and are not the same as nursing homes. ALPs provide patients with room and board, supervision, therapy, and nursing services.

Qualifying for an ALP

ALPs have limited enrollment, so it is important to know who is eligible to use Medicaid for this kind of care. In 2018, the monthly income limit for an ALP was $1,441; anything higher disqualifies a patient. Additionally, the patient must meet the following criteria:

  • Requires the ALP because no other home or suitable environment is available
  • Does not need 24-hour nursing care
  • Is not a danger to other residents
  • Is not bedridden

Alternative New York Programs Covered by Medicaid

New York has several programs for home health care that provide services such as nursing, therapy, bathing assistance, medication management, meal preparation, and cleaning. In some cases, residents in assisted living facilities who are not in an assisted living program can have these services administered to them in the facility where they stay.

Examples of managed care programs in New York include:

  • Program for All-Inclusive Care for the Elderly (PACE)
  • Managed Long-Term Care (MLTC)
  • Personal Care Services Program (PCSP)
  • Consumer Directed Personal Assistance Program (CDPAP)
  • Long-Term Home Health Care Program (LTHHCP)

For each of these, a doctor must order the services for the patient according to the requirements of the program. The PSCP is managed by the local social services district, who will send a nurse assessor to the patient’s home. An interview will provide an assessment of the need for assistance and determine what services the patient receives. The service provider is selected by the social services district.

The CDPAP is different from other programs in that the patient has the right to choose and supervise the service provider. If the relationship is not working, it can be terminated in favor of a different provider. In addition to personal care services, this program also covers skilled nursing services. The goal of the LTHHCP is to allow patients to stay in their homes for as long as possible and deliver services to them instead of moving them to an institution for care.

Each of the options for Medicaid beneficiaries has its own requirements and deadlines. While applying for Medicaid or any of the assisted living programs offered by Medicaid does not require an attorney, working with one who specializes in elder law can be an invaluable resource.

Brooklyn Elder Law Lawyers at Korsinsky & Klein, LLP Help Clients Navigate Medicaid Programs

Trying to get the best care for your elderly loved ones can be a daunting and stressful endeavor. The experienced Brooklyn elder law lawyers at Korsinsky & Klein, LLP can guide your family through the process and ensure your loved one is receiving the care they need. Call us today at 212-495-8133 or contact us online today to schedule a consultation about your case. From our offices in Brooklyn, New York, and Lakewood, New Jersey, we assist clients from the surrounding areas, including Manhattan, Long Island, and Westchester, New York.