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Will Medicaid Pay for Assisted Living?

KSMH Law Group, PLLC July 8, 2022

In Texas, assisted living is available to seniors and older adults who require various levels of personal and medical care but want to maintain a level of independence. Due to the associated cost, a lot of individuals are often concerned about paying for assisted living. However, depending on your coverage, the Medicaid program may be able to cover some services. An experienced Texas estate planning attorney can enlighten you about your options to pay for assisted living.

At KSMH Law Group, PLLC, I’m committed to offering personalized legal counsel and reliable advocacy to clients in estate planning-related matters, including Medicaid planning and assisted living. I’m available to discuss your personal situation and explore your senior care options. Also, I can help determine your eligibility for Medicaid, as well as whether it will cover the cost of assisted living. My firm is proud to serve clients across San Antonio, Live Oak, Kirby, Universal City, and Leon Valley, Texas.

Will Medicaid Pay for Assisted Living?

Medicaid is a government-sponsored insurance program that provides medical coverage to several Americans, including people with low income, older adults, children, pregnant women, and individuals with disabilities. The Medicaid program is funded jointly by both the federal and state governments.

Seniors and older adults who want to live independently, but need medical and non-medical custodial care, may seek financial assistance under the assisted living program. However, the exact services under assisted living that Medicaid covers usually vary by state, as well as the type of coverage the senior applies for.

In the state of Texas, Medicaid covers the cost of services offered in an assisted living community through the state’s STAR PLUS program. Keep in mind that it doesn’t cover the cost of room and board. Texas Medicaid also pays for several personal support services (non-medical) to help older adults continue living in their homes. An experienced attorney can enlighten you about the services that are covered and determine your eligibility.

Who Qualifies?

In order to qualify for Medicaid for the Elderly & People with Disabilities (MEPD) in Texas, you must meet the following requirements:

  • You must be a Texas resident

  • You must be a U.S. citizen or a qualified non-citizen

  • You must be 65 years or older

  • You must meet the income limit – at most $841 (singles) or $1,261 (couples)

  • You must meet the resources or asset limit – at most $2,000 (singles) or $3,000 (couples)

Failing to meet all these requirements does make you ineligible or prevent you from becoming eligible for Medicaid. A knowledgeable attorney can help you understand the costs that are covered under Medicaid and explore your options.

What Costs Are Covered?

The following services are generally covered under Medicaid for the elderly & people with disabilities:

  • Personal care services

  • Regular checkups by a qualified physician

  • Home care or homemaker services such as laundry, meal preparation, and light housekeeping

  • Hospital care and services

  • Vaccines and medicine

  • Hearing and vision care

  • Personal emergency response

  • Laboratory tests and X-rays

  • Treatment of pre-existing conditions and special health needs

  • Access to mental health care and medical specialists

  • Transportation

The amount of coverage will depend on the level of care needed and other surrounding circumstances. Nonetheless, getting the right coverage ensures that you do not have to pay for all the costs of assisted living with your income and assets. 

As mentioned earlier, Medicaid doesn’t cover the cost of room and board. This often accounts for almost half the cost of assisted living. A skilled lawyer can explore your available options to cover the remaining costs and help seek out alternatives—including charities and private programs—for financial support.

Legal Guidance You Can Trust

Aging comes with many limitations, and older adults may need assistance with different tasks. Unfortunately, many seniors who need personal and medical care often find it difficult to pay for these services. Thankfully, Medicaid programs in Texas offer some level of financial assistance for the cost of assisted living. A skilled estate planning attorney can determine your eligibility and educate you about the services that are covered.

At KSMH Law Group, PLLC, I’ve devoted my career to providing outstanding legal services and reliable advocacy to clients in the legal matters of assisted living and Medicaid planning. As your legal counsel, I can help you understand the assisted living services that Medicaid covers, determine whether you qualify, and explore your options for long-term care costs. I will work diligently to address your needs and concerns and help seek assisted living communities that best suit you and your loved one’s personal care, medical needs, and financial requirements.

Contact my firm—KSMH Law Group, PLLC—today to schedule a simple consultation with an estate planning attorney. I can offer you detailed legal counsel and help you find the right resources to cover the cost of assisted living and long-term care services. My firm proudly serves clients across San Antonio, Live Oak, Kirby, Universal City, Leon Valley, and the rest of Texas.