Paying for Long Term Care

Special Care Programs

Assisted Living

Assisted living is a congregate, residential setting that provides or coordinates personal care services, 24-hour supervision, assistance (scheduled and unscheduled), activities and health-related services.

Assisted living is a largely private-pay setting. Most long term care insurance policies today also provide coverage for assisted living services. Although an increased amount of government funding is being made available for assisted living, the overall involvement is not yet substantial. Several government programs provide funds for qualifying individuals that may be used to pay for assisted living services. The most widespread of these programs is Supplemental Security Income (SSI). Individual states sometimes provide funding through Social Services Block Grants or other state-initiated programs. Historically, Medicaid has not been a factor in assisted living; but, as of 2002, 41 states had state plans, Home- and Community-Based Service (HCBS waivers), or Section 1115 waivers that allow at least some Medicaid funding for assisted living services. According to the National Academy for State Health Policy, a number of additional states are planning to offer Medicaid funding for assisted living services. Please inquire at your state Office on Aging for details.

Persons with Mental Retardation or with Developmental Disabilities (MR/DD)

Medicaid is the primary payer of MR/DD services for persons with mental retardation or developmental disabilities, although some clients are considered disabled children and may access their parents' Medicare and Social Security. Most individuals who receive MR/DD services have severe or profound mental retardation and other disabilities often associated with concurrent impairments in adaptive behavior.

Veteran's Programs

The Department of Veteran's Affairs (VA) provides care in its own facilities to veterans in need of skilled or intermediate nursing care. The VA also provides both skilled and intermediate care to veterans through contracts with community nursing homes. Beds are available to all veterans on a space-available basis. Contact your local VA office for more information.

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