Skip to main content
Tag

assisted living

Medicaid for Assisted Living

By Uncategorized

Assisted Living

The RI Medicaid program covers assisted living services in State-licensed Assisted Living Residences (ALRs) that are certified to participate in the long-term services and support (LTSS) program. Covered services include on-site, 24-hour personal care assistance, homemaker and chore services, medication management, therapeutic, social and recreational activities, and health-related transportation. The amount of these services a person receives may differ based on the scope of their needs.

Medicaid does not cover ALR room and board and add-on services. A person who chooses this Medicaid LTSS option must pay from other resources housing charges and any non-Medicaid covered services (like cable and internet access) they choose to receive from the ALR. To ensure individuals applying can afford these costs, the dollar amount a certified ALR can charge for housing each month is capped. Rhode Island also has a State Supplemental Payment (SSP) program that provides financial help to low-income Medicaid beneficiaries living in ALRs. Depending on the scope of a person’s needs, access to some of the Medicaid certified assisted living residences may not be available.Assisted Living Activities

How to receive services

Case management agencies contracted by the Office of Healthy Aging assist individuals in completing a Medicaid LTSS application, assess the scope of their needs, and assist them in developing a person-centered plan of care. These agencies are also responsible for monitoring the delivery of services in the plan of care and coordinating linkages to benefits across community-based health and social service agencies.

Related Service

Nursing and skilled therapy services are not part of the Medicaid-assisted living services but may be authorized by Medicaid and/or other health insurance, as ordered by a physician.

Who is Eligible?

Adults 19-65 with disabilities, or anyone 65 or older who is eligible for Medicaid LTSS.

Need Assistance Applying?

For more information about Medicaid covered assisted living services and to apply for the same, call THE POINT at 401-462-4444.

A list of assisted living communities is located here

 

What are the 4 Alternatives to Nursing Homes?

By Uncategorized

“I don’t ever want to go to a nursing home.”

Certainly, when people are asked to list goals in life, “living in a nursing home someday” is never on the list.

There are however 4 commonly used alternatives for seniors and elders prior to the need for living in a fully skilled nursing home:

1. Continuing Care Retirement Communities (“CCRC’S”)  can provide an alternative solution for many. Such village_at_waterman_lake_assisted_livingcommunities vary enormously in their structure. Some provide life care i.e. an individual may start by living in an apartment, may move to an assisted living wing -where nursing staff is available if necessary and meals may be provided, and intermittently or finally move into the nursing home portion of the community. Many such communities require up-front fees ranging from approximately $25,000 to $900,000 which may or may not be refundable in part or full upon the death of the resident. In addition, there are monthly fees ranging from a few hundred dollars to a few thousand dollars. Frequently, these communities self-insure and guarantee lifetime health care for the residents.

2. Adult Day Care Centers– are similar to child day care centers with which we are more familiar. Adults who need supervision, due to cognitive and/or physical impairment, can be “dropped off” at the beginning of the day. Nursing staff and programming is available throughout the day and the individual returns home for the night. Most long term care policies will pay for adult care.

3. Home Health Care – is another way of dealing with long term illnesses. Most individuals prefer to remain in their own homes for as long as possible. If you were to have a long term care policy of insurance, most comprehensive policies address this preference. Most policies will pay for home health care only if provided through a licensed home health care agency. Some policies will pay for home health care at a percentage of the full nursing home daily benefit amount. A new type of life care at home plan based on the concept of CCRC’s (requiring an upfront fee and a monthly payment) is now being marketed in some areas.) However, if you should not have a LTC policy, many families find themselves private paying for these services or possibly applying for Medicaid if eligible and receiving in-home care services.

4. Assisted Living – many people who live in nursing homes do not really belong there. Frequently, individuals can function very well in an assisted living or personal care facility. These are licensed facilities which often enable individuals to remain in an apartment-like setting. Meals are usually provided and nursing staff is available to help adNewport_Lighthouse_RI_MIminister medicines, handle emergencies, assist when necessary. Often personal care facilities cost about one half as much as nursing homes. Long term care policies generally pay benefits in assisted living facilities as long as the individual qualifies under the terms of the contract. In Rhode Island there are 35 Assisted Living Facilities. The average cost of Assisted Living in Rhode Island is $5,325 per month.

 

Want to learn more about how you can help a loved one plan for their future needs?  Contact our office to schedule a no cost consultation.