Medicaid and the Assisted Living Program

On Behalf of | Jan 6, 2021 | Medicaid eligibility |

While Medicaid does help cover the costs of nursing home care for those who meet the qualifications, you may prefer to live in an assisted living facility. This is frequently an option for people who cannot live alone but do not yet need the level of care that a nursing home provides. At an assisted living facility, you may receive daily living assistance such as meals and housekeeping in addition to nursing case management, for example. Assisted living facilities are also frequently less expensive than nursing homes.

The New York State Department of Health explains that the Assisted Living Program makes this level of care possible for some Medicaid recipients.

Eligibility

You must be medically eligible for nursing home placement to qualify for ALP services. This is not to say that you require a significant amount of care, but that you would otherwise have to move into a nursing home because your home environment is not suitable for your needs.

You do not qualify if you need continual nursing care or if you are bedfast, as these facilities do not usually provide this level of assistance. The ALP is also not for people who have impairments that put the safety of others at risk.

Limitations

The number of people receiving ALP services cannot exceed 4,200; about 85% of those in the program are on Medicaid. As a Medicaid recipient, you must request approval in advance for the ALP services from your local Department of Social Services.

If you are looking ahead at your future long-term care options, you may need to take some early steps to qualify for Medicaid coverage.