Your loved one deserves the best.
Unfortunately, the cost of quality assisted living care is high. Medicaid Waivers can help ease the financial burden, but as with all conversations surrounding Medicaid, they can be confusing.
To offer some clarity, here are answers to common questions:
What Is A Medicaid Waiver?
The Medicaid Waiver Program provides necessary services to people who would otherwise need to stay in facilities such as hospitals or nursing homes.
This gives individuals the freedom to receive assistance while living at home or within a community like Silver Birch. Here in Indiana, home and community-based services (HCBS) are available through the Aged and Disabled (A&D) Waiver.
Who Is Eligible For Medicaid Waivers?
For Hoosiers considering assisted living, they must:
- Be aged, blind, or otherwise disabled
- Live or be transitioning into an HCBS-compliant setting
- Have income no greater than 300% of the maximum Supplemental Security Income amount
- Meet “nursing facility level of care”
To learn more, visit Indiana’s Aged and Disabled Waiver page.
What Is “Nursing Facility Level Of Care”?
The phrase refers to the minimum level of care needed and could include a variety of circumstances. This excludes individuals who do not require nursing services.
Everyone who applies for Medicaid is evaluated during the application process.
What Is The Difference Between Nursing Homes And Assisted Living Communities?
Although they’re often used interchangeably, there are significant differences between the two.
Assisted living communities are designed as a residential setting. Residents often live in their own private apartment or suite. Residents in assisted living do not require constant care but need assistance in various activities of daily living and ongoing health monitoring. The focus is on care support services that are individualized for each resident, such as bathing, dressing, grooming, and medication assistance. Ultimately, this setting allows residents the ability to enjoy their independence in a more relaxed, healthy, and social environment. It is maintenance-free living with housekeeping, laundry, and transportation services; as well as a full calendar of events to keep the residents engaged and active. Assisted Living is a wonderful place for seniors unable or not desiring to live at home alone and not requiring skilled services around the clock due to more medically or cognitively complex conditions.
Skilled Nursing Facilities, also called Nursing homes, offer a medical setting. This environment is typically for those needing a short rehabilitation stay after a hospitalization or a long-term permanent stay due to significant medical needs. The living spaces typically do not include additional rooms such as kitchens; and often incorporate roommates in a single room and a shared bathroom. Nursing home residents require skilled care that is available 24 hours a day. For example, if someone needs skilled medical treatments from a nurse, 24-hour security monitoring or therapy services daily, they would be best suited for care delivery in a nursing home.
Each community, assisted living community, or skilled care facility, is unique in the services and common areas provided in their setting. Additionally, there is regulatory oversight for both settings that vary based on the designation of assisted living or skilled care facility.
Do I Need Medicaid Before Getting The Waiver?
No. Individuals can apply for a Medicaid Waiver before applying for Medicaid.
How Do I Apply For A Medicaid Waiver?
You can apply through your local Area Agency of Aging.
However, a simpler option is to work with an eligibility coordinator here at Silver Birch. Our experienced team will walk you through the process so you aren’t left alone to figure out the confusing process and paperwork. Each of our nine Silver Birch locations in Indiana have an eligibility coordinator who can assist you and answer any questions.
Medicaid Waivers are only a piece of the puzzle. To better understand the connection between Medicaid and assisted living, get the answers to even more questions.