What is memory care? The term “memory care” sounds simple enough, as it is a type of residential long-term care that is tailored to those with Alzheimer’s or other dementias. However, it can get complicated when it comes to understanding the different benefits available to help with the cost of “memory care”, including Medicaid.

When someone calls our office and has a loved one in memory care, it is important for us to establish exactly where their loved one is residing. Memory care can be provided in a nursing home, assisted living, retirement communities with continuing care, or even some home-care situations. Knowing where their loved one is placed can tell us how the facility is licensed, and thus tells us which Medicaid program will apply. Nursing facilities and assisted living facilities are licensed differently which means they are covered under different programs, with different policies. Additionally, Medicaid coverage is also state specific. The Medicaid program for Kansas is KanCare, and for Missouri, it is MO HealthNet.

Missouri Assisted Living

For a Missouri resident in assisted living, Medicaid coverage is through a grant program called the Supplemental Nursing Care (SNC) grant. To be eligible for this grant, the resident must meet the necessary asset requirements. Medicaid looks at the difference between the resident’s income and the monthly cost of the assisted living. Based on that difference, the resident may receive a check for up to approximately $300 per month to help cover the cost of care.

Kansas Assisted Living

In Kansas, the assisted living Medicaid coverage is through a program called Home and Community Based Services (HCBS).

An important thing to keep in mind regarding assisted living is that the monthly bill includes room and board, as well as all the other additional care services provided. However, Medicaid will only help with the medical services portion of the bill. The resident is responsible for paying any room and board costs on their own. If a person is eligible then Medicaid will do an assessment of the person’s care needs to determine coverage. Unlike Missouri’s limit of around $300 per month, there is no limit for HCBS.

Nursing Home

To qualify for Medicaid in a nursing home setting, one must meet the medical requirements for placement in a nursing facility called the activities of daily living, or “ADL’s”, which include things like bathing, dressing, eating, etc. Then one must meet the income and asset limits set by each state.

Once both the physical and income and asset limit criteria are met, Medicaid will help cover the expenses. Unlike assisted living, the entire cost in a nursing facility is a “medical” expense. Therefore, Medicaid will simply calculate a monthly payment the resident must make based on their income. Medicaid covers the remainder of the monthly nursing facility costs, as well as prescriptions and other medical expenses. The resident is given a small personal allowance each month, set by the state, typically around $50-60 to use for things like haircuts, clothing, magazines, etc.

Please note that these numbers change frequently, and with the many variations between Kansas and Missouri, it is imperative that you do not try to navigate the Medicaid waters alone. An experienced KC Elder Law attorney can guide you through the process and ensure that your loved one receives the care they need, without having to worry about the cost.