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Mikki1965 Posted January 2023

My mom is becoming unable to live on her own. Will Medicare pay for assisted living or a care giver?

Also, how do I help her to go to an assisted living facility? She will not want to go. She will be afraid and untrusting.

my2cents Jan 2023
Medicare doesn't pay for either of those things. Post hospitalizations can get listed days at rehab. In home care can be phys or occupational therapy, podiatry and the physical therapy company might be able to arrange some Dr visits. That's about it.

Inhome care is usually more than NH care, so they aren't going to pay for full time care at home. AL is usually too pricey versus a nursing home. AL is really self pay for those who have money. In some states there are some AL facilities who some on this site say, take medicare. Call some in your area

JoAnn29 Jan 2023
Medicare usually only pays in home care after a Hospital visit or extended Rehab. Its usually for PT/OT and you get an aide for bathing. But thats short-term and once Medicare feels they have hit their plateau, that stops. There is something called "intermittent care" that Medicare pays for that one of our Members was able to get for her Mom and an Aunt.

Medicare is Moms health insurance that will pay for Rehab if needed. Mom needs a suppliment to pick up the 20% Medicare does not pay.

Medicare Advantages are contracted out by Medicare. They are suppose to pay your A&B and have additional benefits. If Mom is on one of these, see if they cover any in home care.

Medicaid is for those who cannot afford health insurance, in home care or Long-term care. There is a different criteria for each. They usually have offices in your Social Services building.

Assisted living and Memory Care are private pay. In my State, you must pay privately for at least 2 yrs for Medicaid to be considered. LTC facilities are also private pay unless your Mom assets are under the Medicaid cap. Same with monthly income like Social Security and pension. Must be under the income cap. There are Miller Trusts and OIT trusts that can be set up for any overage so you can qualify for Medicaid but u need to be in a State that allows it.

Call and talk to a Medicaid caseworker. Ask what is the cap for assets and cap for income. Ask if there are any waivers for AL.

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NeedHelpWithMom Jan 2023
I’m sorry that you are struggling with this situation.

Medicare pays for home health visits for an aide to help with basic needs such as bathing, a nurse to oversee care and OT and PT or rehab in a facility if these services are needed.

Medicare won’t pay for permanent residency in a facility. Medicaid will pay for a skilled nursing facility in my area but not for an assisted living facility.

Have you contacted Council on Aging in your area to get a needs assessment?

BurntCaregiver Jan 2023
Medicare does not pay for any kind of residential care. Medicaid will not pay for assisted living either.
She may be able to get some hours of homecare service paid for if her doctor orders it. Medicare or Medicaid will not pay for a live-in caregiver for her though.

Bridget66 Jan 2023
Medicare does not pay for assisted living. Contact Area Agency on Aging to see if they have suggestions. Medicare does not pay for a caregiver at home either.

Geaton777 Jan 2023
Medicaid is the program that (in most states) only pays for long term care (LTC). One must qualify for Medicaid both medically (need for LTC) and financially. A very few states have Medicaid programs that pay for AL. Most states have a 5-year look-back period on the application.

Your profile says your mother has never been diagnosed but is very paranoid. Start by getting her to the doctor for a cognitive and memory assessment. SHe also needs to be checked for other medical issues that can mimic dementia symptoms, like a UTI, thyroid problem, vitamin deficiency, dehydration, HBP, diabetes, stroke, etc. These must be discounted before a more accurarte diagnosis can be made. Then maybe you can discuss meds for anxiety for her. If she has dementia she is less and less able to bring herself to a place of calm on her own.

Teepa Snow has great videos on YouTube to educate caregivers so they can have a better tools to interact with their LOs with dementia for more peaceful and productive daily interactions.

BarbBrooklyn Jan 2023
Welcome. Mikki!

No, Medicare does not pay for long term care.

Most Assisted Living facilities are private pay.

What does mom's physician say about her paranoia? Has she ever been seen by a geriatric psychiatrist?

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