How Does Colorado Medicaid Pay for Assisted Living?

Author

Stacy's Helping Hand

For more information about the author, click to view their website: Stacy's Helping Hand

Posted on

May 16, 2024

Does Medicaid pay for Assisted Living? Medicaid is funded in part by the federal government and in part by the states. If you are confused about Medicaid, you aren’t alone. The Federal and State government are continuously changing rules surrounding healthcare, making it difficult for many people to know if they are using the correct information and making the right choices. Below, we’ve gathered some of the main benefits and drawbacks as well as some links to our vetted resources. Or, feel free to give our team at Stacys Helping Hand, Inc a call at the number above if you would like a Denver assisted living expert to help provide some clarity.

Does Medicaid Pay for Assisted Living

In Colorado, you can apply directly to Medicaid on your own, or you can choose to get Medicaid through the PACE program. In the Denver area, the program is called the InnovAge Greater Colorado PACE. We recommend utilizing InnovAge if the centers are conveniently located due to the fact that many of the assisted living facilities that don’t accept Medicaid will accept payments through InnovAge. The drawback is that InnovAge centers are in limited zip codes and require that you go through their network of experts. For difficult cases, you might need to talk to a local medicaid expert.

Medicaid Benefits

If you have limited assets, low income and you need help paying for nursing home or assisted living care, Medicaid might help you pay for part of your care. Nursing home and assisted living services are considered types of long-term care. Long-term care consists of not just medical services, but also personal services. For example, a resident in a nursing home might pay for assistance with bathing and dressing in addition to medical treatment. Medicaid rules for long-term care are significantly different in many ways than their rules for other services.

Medicaid Drawbacks

Medicaid may not be the best source of funding for assisted living depending on your situation. The first questions most often asked is whether Medicare will pay for assisted living. The answer is no. Medicare is strictly health insurance. Long Term Care Medicaid pays about 30% less than what’s needed for most assisted living costs. Medicaid will cover up to $2250 a month at most.

Since Medicaid reimbursement rates for assisted living facilities are not high, many assisted living communities don’t accept Medicaid. The ones that do are often shared living communities. Also, given the limited range of services for which Medicaid provides assistance and the enrollment caps and waiting lists for Medicaid waivers, many families might benefit by finding affordable assisted living outside of the Medicaid system.

Eligibility

For those who need help with assisted living in Denver, adults without dependent children whose household income does not exceed 133% Federal Poverty Level can apply here and will also need to apply for an Elderly Blind and Disabled Waiver (EBD Waiver). If they already have Colorado Medicaid Insurance, then they would apply for the Medicaid EBD Waiver. This waiver is what will contribute to covering the costs of assisted living.

We’ve written in more depth about the financial eligibility aspects of Long Term Care Medicaid (EBD Waiver) in Paying for Assisted Living Facilities: Spend Downs. In a nutshell, Long Term Care Medicaid requires you to contribute most of your income for room and board when you are living in an assisted living and the EBD Waiver will supplement the facility for your care. You are allowed to keep a small fixed amount of money as a “personal needs allowance” to pay for snacks, clothing and personal products.

There are spousal protection rules, but if you need that much detail, we’d recommend talking to a local expert. You can give us a call at Stacy’s Helping Hand, Inc at 720-248-7758

Other Articles You May Like

Assisted Living vs. Nursing Homes: Are they the same?

When it comes to various housing and care communities for older adults, one of the most common misconceptions is that assisted living and nursing homes are essentially the same thing.The simple answer is, they are not. Heres how they are different:Nursing Homes Provide Skilled Medical CareNursing homes are designed for individuals who require ongoing medical supervision and skilled nursing services.Residents may:-Have complex medical conditions-Need rehabilitation after hospitalization-Require around-the-clock nursing care-Depend on specialized healthcare services, labs, medical oversight and moreMedical staff are available 24 hours a day to provide clinical care and monitor residents health in a nursing home.Assisted Living Focuses on IndependenceBy contrast, Assisted Living emphasizes lifestyle, independence, and support.Residents typically:-Live in private apartments or suites-Participate in community activities, programs and events-Receive assistance with activities of daily living, but not necessarily around the clock-Maintain greater control over their daily routinesFor many older adults, assisted living offers the right balance between support and independence. Staff provide care and guidance, but not so much that the individual is bedridden, highly monitored or restricted to a hospital-like setting.At Kavod Senior Life, Assisted Living residents enjoy the best parts of living as Kavod lifts the struggles and isolation of individual home life outside a community. Benefits include:-Three meals a day in a family-style dining environment-Activities such as music, lectures and outings (at no extra cost!)-Housekeeping, laundry and bed-making-Medication monitoring-Five wellness checks per day-On-site access to geriatric medical clinics, physical/occupational and speech therapy, and a variety of health clinics-Available add-on services (oxygen management, incontinence care and escorting to appointments around campus)-Affordable rents that are 66% below market rate in the Denver area!If youre wondering whether a nursing home or Assisted Living is right for you or your loved one, consider the tips above to help you make that decision. We are always happy to discuss your options with no obligation. Contact us today for assistance!Created with the assistance of ChatGPT

The Bridge to Independence: A Story of Integrated Care in Colorado

For years, home was a place that felt more like a memory than a reality for one senior who spent most of his time moving between hospitals and rehab centers. As someone relying on Health First Colorado, his healthcare journey was often exhausting and repetitive until he found a way to bridge the gap between needing help and wanting to stay in his own favorite chair.A Lifeline through Colorado Medicaid Remote Support ServicesEverything changed when he started a new routine that combined four hours of daily help from a caregiver with the around the clock security of Colorado Medicaid remote support services. While his caregiver focused on making sure his home was clean and his meals were delicious, the remote support team acted like a quiet guardian watching over him through the day and night. By using simple devices to check his blood pressure and oxygen levels, he was never truly alone, and his remote coordinators became familiar voices who checked in on him with a friendly call every single day.Technology that Catches the Small DetailsThe true value of this hybrid care became clear when his daily vitals showed a trend that no one would have noticed otherwise. His remote team saw his blood pressure was dropping to a level that made him feel lightheaded, and they immediately coordinated with his doctor to adjust his medication before he could have a dangerous fall. Even during a sudden bout with an infection, he was able to use his emergency button to keep everyone informed while he was being helped by paramedics, ensuring that his care team was right there with him every step of the way.Six Months of Staying Home After a lifetime of being told he needed to be in a facility, he has now spent six months thriving in his own home with only one very short hospital stay. This story proves that when we combine human heart with the power of technology, staying home is not just a dream but a reality that is accessible through programs like Colorado Medicaid.

A Path to Wellness: Care That Continues at Home

Returning home from a hospital stay can challenge anyone, especially people with chronic conditions. For Colorado Medicaid members, Remote Support Services simplify this transition. Our program provides comprehensive support right in your home, ensuring a smooth and safe return to your daily life. We use technology to monitor your health, empowering you to take an active role in your wellness journey and prevent future complications.Our Post-Hospitalization ProcedureOur simple process focuses on your well-being: Initial Contact: A member or family member contacts our agency to discuss their needs. Service Determination: We assess the members condition and decide if our chronic disease management services are right for them. Coordination with County/Case Manager: We contact the members case manager or county to confirm their benefits are initiated or enrolled. This step ensures a seamless process and proper coverage under Health First Colorado, the states Medicaid program. Initiating Remote Monitoring: Once we have confirmation, we start the member on remote monitoring to ensure their safety and track their progress. This allows us to proactively address any potential issues. Continuation Discussion: After the initial three-month period, we discuss continuing services to ensure the member continues receiving the care they need to maintain their health. How We Monitor Your HealthOur remote monitoring program uses easy-to-use, at-home equipment to help you track your health vitals and communicate with your care team. The program combines devices and daily check-ins: Bluetooth-enabled blood pressure cuff: For those with hypertension or heart conditions, this device automatically sends your blood pressure readings to us, giving us a continuous picture of your cardiovascular health. Bluetooth-enabled weight scale: We use this to monitor for sudden weight changes. For conditions like heart failure, a significant, rapid weight increase can signal fluid retention and may need prompt attention. Pulse oximeter: This small device clips onto your finger to measure your blood oxygen saturation and heart rate. Its especially useful for managing conditions that affect breathing, such as COPD or asthma, and provides a quick look at how well oxygen gets to your body. Daily phone questionnaire: You will have a brief daily check-in with your remote care coordinator by phone. This allows you to report on how youre feeling, discuss symptoms, and ask questions. This personal touch ensures we can provide timely support and adjust your care plan as needed. This regular monitoring allows our team to identify changes and intervene early, preventing complications and giving you a sense of security at home.Benefits of Chronic Disease ManagementOur chronic disease management program offers significant benefits to Colorado Medicaid members: Improved Health Outcomes: With continuous, proactive management, members can better control their chronic conditions, reducing the risk of complications and future hospitalizations. Enhanced Access to Care: Using technology and telehealth services, our program helps overcome barriers to care, ensuring members have timely access to medical advice and support. This particularly benefits those in rural or underserved areas of Colorado. Better Care Coordination: Our team serves as a central point of contact, facilitating communication between all healthcare providers involved in a members care. This ensures a well-coordinated treatment plan and effective communication of any changes. Increased Patient Engagement: By regularly monitoring their vitals, members become more engaged and knowledgeable about their own health. This empowers them to make better lifestyle choices and stick to their treatment plan. ConclusionOur remote support program provides seamless, personalized care for Colorado Medicaid members after a hospital stay. This approach benefits both the individual, by empowering them to manage their health safely at home, and the healthcare system, by ensuring resources are used efficiently and effectively. If you or a loved one are a Colorado Medicaid member returning from the hospital, our remote supports program can be a critical step toward long-term wellness and independence.  

Local Services By This Author

Stacy's Helping Hand

Housing Placement & Resource Specialists 1040 South Gaylord Street, Denver, Colorado, 80209

Let us help you find the best care and housing option for your loved one - Assisted Living, Independent Living, Memory Care or Skilled Nursing. As Senior Care Advisors with over 16 years experience, we know the level of care each community or small home provides, their reputation and cost. We will help determine your loved ones physical care needs and what will be the best fit for them socially. As a neutral party, we tour the communities/homes with you and help you ask the right questions. We stay with you as your liaison, sounding board, and advocate for 3 months after you move in.  Read our 5 Star reviews on Google and Yelp!

Stacy's Helping Hand

Memory Care 1040 South Gaylord Street, Denver, Colorado, 80209

Let us help you find the best care and housing option for your loved one - Assisted Living, Independent Living, Memory Care or Skilled Nursing. As Senior Care Advisors with over 12 years experience, we know the level of care each community or small home provides, their reputation and cost. We will help determine your loved ones physical care needs and what will be the best fit for them socially. As a neutral party, we tour the communities/homes with you and help you ask the right questions. We stay with you as your liaison, sounding board, and advocate for 3 months after you move in.  Read our 5 Star reviews on Google and Yelp!

Stacy's Helping Hand

Assisted Living 1040 South Gaylord Street, Denver, Colorado, 80209

Let us help you find the best care and housing option for your loved one - Assisted Living, Independent Living, Memory Care or Skilled Nursing. As Senior Care Advisors with over 12 years experience, we know the level of care each community or small home provides, their reputation and cost. We will help determine your loved ones physical care needs and what will be the best fit for them socially. As a neutral party, we tour the communities/homes with you and help you ask the right questions. We stay with you as your liaison, sounding board, and advocate for 3 months after you move in.  Read our 5 Star reviews on Google and Yelp!