Under Medicaid is room and board provided?

There are Medicaid beds in some nursing homes. My dad and grandmother both had Medicaid and it paid for everything they needed, but they were not allowed to keep their Social Security checks. I think that went to the nursing home.

Medicaid is state specific in its program provisions. In my state it never pays for assisted living, only skilled nursing care. It paid for all of my mother’s nursing home care after the funds available for private pay and her long term care insurance ran out. The nursing home always received her small SS benefit. Look for what’s covered in your state but in most states it’s nursing home care

One has to qualify both medically and financially. In my state Medicaid (MN) covers SN and LTC. Medicaid covers one's medical costs and their SS income covers the room & board. In many states the financial application's look-back period can be five years from date of application.

The patient need to qualify, apply and be approved for Medicaid LTC. This is separate from Community Mediciad insurance. There is no crossover that automatically allows Mediciad LTC if currently receiving community medicaid benefits.

The facility needs to be an approved Mediciad LTC facility with an open bed.

When the patient is under Medicaid LTC they will pay all income received (less Personal fund allowance amount) and will need to maintain personal assets under or exactly at the state threshold.

Medicaid for Longterm care in a facility does cover room and board. The recipient will need to hand over their Social Security and pension to help offset the cost of their care. If there is a spouse, an elder lawyer will be needed to split the couples assets. The spouse needing care will spend down their half and apply for Medicaid. The Community spouse will remain in the home, have a car and enough or all of the monthly income to live on.

It is under your States Long Term Care Medicaid program.

A very big something to keep in mind is that each State administers its many Medicaid programs uniquely by whatever your State legislature decides on funding BUT has to be done within Federal compliance for specific program requirements. LSS what happens for TX LTC Medicaid will be different than NYS or CA.

For example, under Federal laws that created Medicare & Medicare, all States had to have their Medicaid system do a Long Term Care Program to provide for custodial care costs (room and board) for those in a NH/SNF who were both “at need” medically (for skilled nursing) and financially (basically impoverished with a look back). It’s required dedicated funding. But nothing requiring States to pay for other long term residential, like AL or MC. What has evolved is some States do “waivers” to shift some required LTC funding to NH to instead go to AL or MC. ((How much of a shift the waiver can be at is an equation based on demographics & costs of living; it’s real in the weeds policy wonk work and has to be approved by the Feds.)) To muddle this even more, some States do waivers PLUS additional funding for AL & MC room & board costs (AZ does this). Some States do no waiver’s at all. Some pay for AL / MC instead thru Community based Medicaid programs, which depends heavily on annual State budget.

All States have it required (to get Federal $$$) that the person in a NH on LTC Medicaid is required to have almost all their mo income become a Share of Cost (also called resident responsibility) that is paid by them to the NH. (fwiw only way not to have the SOC happen is that there is a still living in the community spouse or other legal dependent who obstensibly themselves needs the now-in-a-NH spouse’s income and this is filed for in the LtC Medicaid application process.) Some States run their program that State pays NH a fixed $ amount day rate reimbursement and the SOC is additional $ NH can make from a resident. While other States, deduct SOC from their reimbursement. You can see why how a State runs its LTC Medicaid matters for if a facility decides whether to participate in LTC Medicaid and if so, then how many beds they set aside for their participation.

Similar for how AL & MC get reimbursed. What most States do is deduct the SOC from a somewhat low Statewide fixed day rate for AL and for MC. Plus waivers & Community based Medicaid are not dedicated funding. It all factors in as to why most AL and MC remain private pay.

For NH as they are SNF for licensing, they can get rehab patients. Rehab paid by health insurance and tends to pay double or triple the LTC Medicaid custodial care day rate for just the butt-in-bed cost alone. For NH, being able to do rehab matters big time for operating costs. Having 1/3 beds rehab patients + 1/3 as private pay custodial care residents + 1/3 as LTC Medicaid custodial care residents = NH can be profitable.

What your State does matters. If you are unsure, every county is within an Area of Aging (affiliated with your Council of Governments) which has information as what’s available in their region for those 65+.