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LTSS

Medicaid for Assisted Living

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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

 

Home Based Medicaid Serivices

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LTSS in Home and Community-Based Settings

Many older adults and people with disabilities who want to stay in their own homes cannot do so without help. The programs that can help you or someone you care for live comfortably and safely at home are called Home and Community Based Services.

Some programs can help you fill prescriptions or get meals or rides. Other programs will help you out at home with activities like personal grooming or getting in and out of bed. The programs you use will be based on your needs.

Medicaid LTSS provides medical care and covers most of the services and supports people need to stay in their homes or a community-setting. People who have the highest or high level of need may get Medicaid LTSS in the home or community setting.

Need to apply for LTSS Medicaid home waiver for a loved one? Contact us.