Can Medicaid Cover Dementia Care Facilities?

As dementia progresses, many caregivers begin to question if Medicaid will cover long-term care. Unfortunately, as the mind begins to decline, it is no longer possible for the individual to continue living independently. Let us discuss what’s covered by Medicaid and what’s not during this time.

Dementia Care

The onset of dementia begins with custodial care: ordinary personal care that does not require qualified medical personnel’s attention. At the skilled care level, your loved one with dementia requires constant medical care to preserve their quality of life.

What role does Medicaid play in this? It provides financial assistance to many people with senior dementia, allowing them to receive the necessary level of care. People with Dementia have access to a variety of care options, depending on the level of care they now require.

In-Home Care

For as long as possible, in-home care has been the preferred care setting for many dementia patients.

In-home care enables people living with dementia to get daily assistance with personal care and other tasks, such as meal preparation, without having to leave their homes.

Medicaid frequently pays for in-home care. The only requirement is that the patient will need to move to a nursing home or other care facility if the in-home care can't be provided.

Nursing Home Facilities

When a dementia patient's condition deteriorates to the point where they can no longer live alone and require intensive medical care, a nursing home is typically the best option.

Nursing homes are intended to provide dementia patients with the necessary care while preserving their quality of life for as long as possible.

Medicaid will pay for nursing home care for patients with dementia.

Memory Care Units

Memory care units are specialized facilities that are tailored to the needs of dementia and Alzheimer's patients.

Patients can engage in structured activities at these facilities. They can participate in social activities, get physical therapy and other medical services as needed, and have meals delivered or served in a dining area.

Memory care facilities provide either private or semi-private rooms. Medicaid does offer coverage plans for memory care units.

Adult Family Homes

Adult family homes are frequently a great alternative for continuing care for people with dementia.

In many instances, these facilities will include approximately six adult patients who are able to interact with each other and the personnel. Patients are more comfortable than they could be in other nursing home-style settings because they stay in a residential house. Occasionally, adult family homes offer occasional medical treatment.

However, Medicaid does not cover these services.

Adult Day Care Programs

Adult day care programs are meant to offer daytime care for persons who are unable to stay at home alone and have no one to care for them, but who do not yet require full-time nursing home care.

In adult day care services, dementia patients are monitored and cared for. In addition, they are able to socialize with other seniors, which can keep their minds sharper and more active for longer.

This is another service that Medicaid often covers.

Continuing Care Retirement Communities

Continuing care retirement communities (CCRCs) are intended to provide a tiered treatment approach. Individuals who are capable of living somewhat independently are granted independence.

As their condition worsens, patients are transferred to higher levels of care within the facility. These services are often not covered by Medicaid, and individuals who prefer to reside in a continuing care retirement community are sometimes required to move in while still able to live independently in order to secure a space when they require higher levels of care.

The spouse of a dementia sufferer can also reside in the CCRC, which is another advantage of this type of environment.

The cost of caring for an aged dementia patient can get high. It might be hard to consider how to pay for the best type of care for a loved one, since many people struggle to find the appropriate care for a family member.

Thankfully, programs such as Medicaid enable families to give their loved ones with necessary care without incurring debt. Research and consideration of the available facilities in a specific location will ultimately provide the most accurate assessment of the care a particular individual needs.

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William Rivers is an editor with a master’s degree in Human Services Counseling at Maine State University. He has more than 20 years of experience working in the senior healthcare industry.
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