The cost of memory care can reach six figures per year. You can pay with private savings and assets or long-term care insurance. In some cases, Medicaid will help to cover the cost of memory care for eligible older adults.
Memory care communities are often located within assisted living communities or nursing homes. The cost of memory care will vary based on the community’s location.
Residents of memory care communities use a variety of methods to pay for their care, including
personal savings, long-term care insurance, and government assistance programs, like Medicaid or veteran benefits, if they qualify.
In 2017, the Journal of the American Geriatrics Society estimated a lifetime cost of $184,500 for someone living with dementia, with 86% of the expenses taken on by
families.
Is Memory Care Separate from Nursing Care?
Memory care communities are commonly located inside assisted living
communities. But assisted living costs often don’t cover memory care expenses like special dementia training for staff or secure wings to prevent wandering. The extra staff qualifications and facilities required could explain the difference in the average monthly cost of memory care—$6,160, according to Dementia Care Central—compared to the median monthly cost of assisted living, which Genworth reported to be $4,500.
Each type of dementia—including Alzheimer’s, vascular dementiaⓘ , and Lewy body dementiaⓘ —progresses differently. The scope of care for an older adult living with dementia will vary widely based on the kind of dementia a person has and how long they have been living with the disease. In the earlier stages, people living with dementia may need few supportive services, but this is an excellent
time to plan for future care needs. As dementia progresses, care needs usually increase, and those with dementia may require a secure unit to prevent wandering, assistance with several activities of daily living, and even skilled nursing care.
Medicare will not pay for any form of long-term care, but residents of memory care may be able to rely
on Medicare for some services, including physician-ordered occupational therapy, physical therapy, and speech therapy; some outpatient health services and prescription drug costs; durable medical equipment; and up to 100 days in a nursing home, following a qualifying hospital stay.
What is Home Health Care?
Home health care is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF).
If you have a Medicare Supplement
Insurance (Medigap) policy or other health insurance coverage, tell your doctor so your bills get paid correctly.
If your doctor or other health care provider (including a nurse practitioner, a clinical nurse specialist, and physician assistant) decides you need home health care, they should give you a list of agencies that serve your
area. They must tell you whether their organization has a financial interest in any agency listed.
Medicare and Medicaid
When medically necessary, Medicare will pay 100% of the cost of nursing home care for the first
20 days in which a beneficiary resides in a nursing home. For days 21 – 100, Medicare will continue to pay a portion of the cost, but in 2022, the nursing home resident will have a copayment of $194.50 / day. After 100 days, Medicare does not pay for nursing home care.
Medicaid will pay 100% of the
cost of nursing home care for its beneficiaries. However, to be eligible for Medicaid nursing home care, the patient must have very limited income and very few financial assets (ballpark limits are assets valued under $2,000 and monthly income under $2,523 in 2022). Medicaid eligibility
criteria is state-specific
Unless there is a medical need for a private room in a nursing home, Medicaid will pay for a shared room only. Some states allow “family supplementation” which allows family members to supplement the payment in order to upgrade their loved one to a private room. Other states consider family
supplementation to be a gift and may disqualify the individual for Medicaid.
https://www.medicaidplanningassistance.org/nursing-home-costs/
In Georgia, Medicaid is a very common source of funding for long-term care. Approximately 72% of nursing home residents in Georgia use Medicaid to pay for their nursing home care. Without Medicaid, long-term care like nursing homes, assisted living facilities, and home health care is unaffordable for most people. In 2018, the
average daily cost of a private room in a nursing home in Georgia was approximately $223, or over $81,000 per year. Private health insurance policies generally do not cover long-term care, and very few people purchase private long-term care insurance policies. Medicare coverage for long-term care services is limited. As a result, Medicaid picks up the tab for many Georgians who need long-term institutional care or home care.
There are several different ways to become eligible for Medicaid in Georgia, and there are specific eligibility rules for long-term care services like nursing homes, assisted living facilities, and home health care services.
https://www.nolo.com/legal-encyclopedia/when-medicaid-georgia-will-pay-nursing-home-assisted-living-home-health-care.html
Do Home Health Care Providers Participate in Medicare?
Approximately 15% of Georgia home care agencies are certified by Medicare.
Georgia Resources for Assisted Living, Home Health Care, Nursing Homes and More
https://www.seniorcare.com/home-care/ga/
More Resources . . .
https://www.dibbern.com/
https://www.dibbern.com/nursing-homes/georgia/cost_for_georgia_nursing_homes.htm
https://www.dibbern.com/nursing-homes/georgia/georgia-nursing-homes-directory.htm