Does Medicare & Medicaid Pay For Assisted Living in Texas?

Jun 12, 2020 | Planning for Long Term Care

This article is part of a 4-part series on relocating a memory care resident to another state or location. Find the rest of the series below.

Choosing a memory care facility from another state
Physically moving a resident to a new facility
How to prepare a person with dementia for relocation

Benefits Overview

Families often ask what benefits pay for assisted living services in Texas? Does Medicare or Medicaid pay for assisted living services? The answer can be confusing and challenging for families to navigate through. In short, Medicare does NOT typically pay for assisted living stays in Texas and Medicaid limited to a specific type of facility with specific eligibility requirements.

Below is a brief overview of the most common benefits in relation to funding of assisted living services.

Private Funds

The large majority of residents who reside in Texas assisted living communities use personal income and assets to support paying for routine services. Organizations offer a variety of service packages and various rates where residents and families can choose what fits their needs best.

Medicare

In general, Medicare benefits for individuals over the age of 65 does NOT cover stays in assisted living communities. Medicare can be described as a federal healthcare insurance program providing short term healthcare services such as acute hospital stays, short term rehabilitation, home health care, hospice and other medical services. For more information on what Medicare covers please visit: LongTermCare.gov

Medicaid

Medicaid eligibility is limited to individuals with limited financial resources. Select communities such as nursing homes may have a set number of dedicated Medicaid assigned beds. Individual eligibility rules apply and a waitlist may be in place at a community. In Texas, the majority of assisted living communities do not accept Medicaid due to the limitations on be. For more information on Medicaid eligibility in Texas and contact information, please visit: Texas Health & Human Services Aging & Disability Resource Center

Long Term Care Insurance

Long Term Care Insurance benefits may cover a portion of the monthly cost if the resident has the appropriate benefit coverage

Veterans Benefits

Veterans Benefits are an option to explore if the individual qualifies for benefits. A listing of qualifications can be found on the VA aid and assistance website.

Conclusion

Assisted Living communities often offer support to family members in navigating funding options for assisted living services and in choosing the right level of services.

Additional Resources:

The Area Agency on Aging in Texas is an organization which offers support services for individuals in need of services to connect with programs and benefits. Please visit the agency website at: Texas Area Agency on Aging

For additional information on funding and financial support for assisted living, please visit: payingforseniorcare.com

To apply for benefits in Texas, visit: Your Texas Benefits

 

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Let’s be honest. Senior care has increasingly become a business. A formula really, with frequent changes in ownership and management, slick marketing pitches, poor care quality, high staff turnover, and a corporate approach that treats residents like a commodity. Sundara is locally owned and operated by a team focused on making a difference; a real difference that families and their loved ones can appreciate. We are not in the business of selling fancy real estate with hyped-up programs and spa services. We don’t provide care from a menu. We don’t have a slew of add-on fees or upcharges. What we do have is a team of owners that share a 12-year history together and unmatched levels of accountability, consistency and flexibility. We also operate from a simple care philosophy based on the premise that residents are a part of our family…NOT a commodity. We look forward to getting to know you and your family. Real care by real people for real families.
Request an Appointment
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