Does your state medicaid cover MCF?

RetiredTeacher

Spoke with CELA yesterday and found out medicare in CA can cover SNF for patients with dementia who need it but does not cover a MCF. We would have a share of cost but at least we wouldn't have to pay the entire amount ourselves. If I'm not able to keep DH with VD home with help until the end, I'm hoping his poor physical health and co-morbidities may make SNF more appropriate. I know that scenario may not happen so I am researching what states with medicaid cover some cost of the cost of MCF. If any of you have researched this for your state I would be interested in finding out what states help with this expense.

annie51

I just found out that in Florida, Medicaid pays full cost of MC at some facilities and only a stipend at other facilities. I didn’t realize they would cover full cost in some cases. I don’t yet know if DH will qualify for Medicaid, but if he does that would certainly be a blessing.

BPS

In Washington An elder law attorney told me that Medicaid covers MCF if the facility except medicaid (not all do) and if you meet the financial requirements. You can keep you house and 1 car and about $150,000 for a couple, but there are ways to shield other money that can help but there are some draw back to them.

RetiredTeacher

Tysvm for your helpful responses. We all hope it doesn't come to that but if it does, the survivor needs the means to continue living. Ty

harshedbuzz

@RetiredTeacher

Yours is a very nuanced question. There are states that do offer Institutional Medicaid that covers all or some of the cost of a bed in a MCF based on assets limits that vary depending on the state and generally track with the COL of the state.

Even in states that do cover MC, I'm told there are sometimes limited waiver funds available. Many facilities do not accept Medicaid and therefore have no beds available and the ones that do, often operate under a business model in which new residents are self-pay for 2-3 years and then convert to a Medicaid bed/semi-private room. These rooms are limited and are offered to those who are already residents so getting in can be a matter of luck.

FWIW, this was very much on my mind when we were making choices for my dad. He'd already lost a big piece of their assets day-trading ahead of his diagnosis, so funds were quite limited and made worse by the decision to move near me where the COL is considerably higher than where they'd retired to. Mom's a retired teacher with a decent pension and great medical insurance which helped, but she also has a number of medical issues (CHF, COPD and severe AMD) that could required AL or a SNF at some point. It pained me to think dad, whose mind was compromised to the point he thought he saw palm trees out his window in suburban Philadelphia might burn through assets in a lovely MCF while mom who'd presumably have the brainpower to understand where she was might end up in a less nice facility.

HB

RetiredTeacher

There are no magic answers for any of this. We try to prepare emotionally and financially but there is no way we can really be prepared for so many uncertainties. I hope for an exit route but that is wishful thinking. I'm hoping I can keep him home with help but will he wander, will he turn violent, or be able to get up if he falls??? So many things we just don't know and can't predict. We keep going day after day the best we can making the best of this sad situation. The financial pic for the future is not pretty so I'm trying not to dwell on the what ifs. To keep my sanity I try to live one day at a time and pray for strength. Ty all for this supportive forum.

Bluebird

Where I live Medicaid will only pay for care at a SNF but if a SNF has a memory care unit attached to the nursing home then Medicaid will cover the cost of the memory care unit. Most SNF also require that you pay full pay for around 2 years before they will accept Medicaid. You also have to meet Medicaid’s requirements for how little money you have left.

Try looking at different memory care units that are attached to a nursing home. Call them and ask if they accept Medicaid as full payment for care and room and board when your spouse meets Medicaid’s eligibility requirements. Also ask how long they require full payment before they’ll accept Medicaid.

tboard

https://alzconnected.org/discussion/73641/does-your-state-medicaid-cover-mcf

Memory care facilities are not covered in Minnesota The who memory care model seems to be designed to take up the most amount of space for the most amount of money and least amount of care. My DH doesn't have any medical conditions other than two kinds of dementia. We can not afford memory care. The care he gets at home is probably better anyway but I wouldn't mind a day off now and then or even a full nights sleep.

JDancer

Your post title mentions Medicaid, but the post says Medicare. I assume you mean Medicaid, since you're asking about differences from state to state. Can you clarify?

tigersmom

Medicaid in New York state does not cover memory care. It will cover nursing home care, but the patient must require skilled nursing. I don't believe a dementia diagnosis alone is enough.

RetiredTeacher

My apologies for my ambiguity. I was interested in Medicaid coverage by state. My husband has several serious medical issues in addition to VD from previous strokes. His legs are getting weaker and standing unassisted is really difficult. His cognitive declineis much slower than his physical decline. I am hoping to keep him home with help but don't know if that will be possible. I was trying to find info about other states Medicaid coverage for MC and SNF. Private pay for 2 yrs will devastate us financially. Looks like the best option is hiring help and keeping him home. Others have talked about Hoyer Lifts, etc. Will educate myself about those aids to help him continue at home until the end. Ty to all who have given input. Your support is a lifeline. Ty