How Medicaid Pays for Nursing Facility Services for Advanced Alzheimer’s

Medicaid plays a crucial role in helping families pay for nursing facility services when a loved one has advanced Alzheimer’s disease. This support is especially important because long-term care costs can be very high, and many people with Alzheimer’s eventually need specialized care that they cannot receive at home.

**What Medicaid Covers for Advanced Alzheimer’s Care**

Medicaid covers essential nursing home expenses, including room and board, for those who qualify in all 50 states and Washington, D.C.[1] This means if someone with advanced Alzheimer’s needs to live in a nursing facility where they can get 24-hour supervision and medical care tailored to their condition, Medicaid can help pay for it.

The program also covers memory care services within these nursing facilities. Memory care is specialized support designed specifically for people with dementia or Alzheimer’s disease. It includes help with daily activities like eating, bathing, dressing, managing medications, and ensuring safety[2]. Because Medicaid is jointly run by federal and state governments, the exact details of what memory care looks like—and how it’s delivered—can vary from state to state[2].

**Eligibility Requirements**

To receive Medicaid coverage for nursing facility services related to Alzheimer’s:

– The individual must meet financial eligibility rules that vary by state but generally require limited income and assets.
– They must need the level of care provided by a nursing home (often called “nursing facility level of care”).
– Many people qualify as they age or become disabled due to their illness[1][2].

It is helpful to contact your State Medicaid Agency because each state may have different programs or waivers that affect eligibility or benefits[1][2].

**What About Assisted Living or Memory Care Residences?**

While Medicaid pays fully for nursing homes’ room and board costs when qualified individuals live there due to advanced Alzheimer’s disease,[1] it usually does not cover room and board in assisted living facilities or standalone memory care residences. Some exceptions exist—for example California offers an Assisted Living Waiver—but these are rare[1][5]. However, some states provide partial coverage through Home- and Community-Based Services (HCBS) waivers which might allow some memory-care-related personal assistance at home or in community settings without full institutionalization[1].

**How Does Medicare Fit In?**

Unlike Medicaid, Medicare does not cover long-term nursing home stays beyond about 100 days after a hospital stay—and even then only partially pays during this period. Therefore Medicare alone cannot fund ongoing advanced Alzheimer’s residential care[4][5]. Many patients rely on both programs: Medicare initially after hospitalization; then Medicaid takes over longer-term funding if eligible.

**Summary**

For families facing the challenge of caring for someone with advanced Alzheimer’s:

– **Medicaid is the primary payer** of long-term skilled nursing facility services including specialized memory care.
– Coverage includes **room & board**, medical supervision, personal assistance with daily tasks.
– Eligibility depends on income/assets limits plus medical need.
– Coverage details differ by state; contacting local agencies helps clarify options.
– Assisted living/memory-care residences often require private payment except rare waiver cases.

In short: If your loved one has advanced Alzheimer’s requiring round-the-clock skilled support in a nursing facility setting—and you meet financial criteria—Medicaid will likely pay most costs involved. This makes it an essential resource enabling access to quality dementia-specific residential healthcare when needed most.[1][2][5]