Medicaid and the Cost of Room and Board in Memory Care
Medicaid and the Cost of Room and Board in Memory Care
When a loved one needs memory care due to Alzheimer’s or dementia, families often face tough questions about how to pay for it. Memory care facilities provide specialized support for people with cognitive impairments, but these services can be expensive. Understanding what Medicaid covers—and what it doesn’t—can help families plan better.
**What Medicaid Covers in Memory Care**
Medicaid is a government program that helps low-income individuals pay for healthcare, including long-term care. For people with dementia or Alzheimer’s disease, Medicaid can cover many medical and personal care services. This includes doctor visits, prescription medications, home health aides, and nursing home care if the person qualifies[1][4][5].
If your loved one lives at home or with family members, Medicaid often pays for personal care assistance through programs like HCBS (Home and Community-Based Services) Waivers or ABD (Aged Blind Disabled) Medicaid[1]. In some states, family caregivers can even be paid by Medicaid to provide this help.
**Memory Care Facilities vs Nursing Homes**
Memory care is usually offered either as a special unit within nursing homes or as standalone assisted living communities designed specifically for people with dementia[1][4]. When memory care is part of a nursing home certified by Medicaid, the program typically covers 100% of the costs related to medical and personal care services there—provided eligibility requirements are met[2][4].
However, if memory care is provided in an assisted living community (a separate facility from nursing homes), things get more complicated.
**The Cost of Room and Board: What Medicaid Does Not Cover**
One important limitation is that while Medicaid may pay for many types of long-term medical and personal support services in memory care settings—including those inside nursing homes—it generally does *not* cover room and board expenses in assisted living residences or standalone memory care facilities[1][3][5].
Room and board means the cost of housing plus meals—the basic living expenses charged by these communities. These costs are usually paid out-of-pocket by residents or their families.
There are only very few exceptions where some states offer waivers that might cover room and board partially—for example California has an Assisted Living Waiver program—but such options are rare nationwide[1].
**Why This Matters**
Because room and board make up a large portion of monthly fees at memory care communities—often thousands of dollars per month—not having this covered by Medicaid means families must find other ways to pay these costs. Options include:
– Using savings or income
– Long-term care insurance policies purchased earlier
– Veterans benefits if eligible
– Selling life insurance policies with accelerated death benefits
– Other financial assistance programs where available
Planning ahead financially becomes crucial since waiting until someone moves into memory care limits options like buying insurance coverage later on[4].
**Summary**
Medicaid plays an essential role in helping cover many aspects of dementia-related long-term caregiving costs but stops short when it comes to paying room and board charges at most assisted living-based memory care facilities. It will fully cover medical-related costs inside certified nursing homes but not housing fees outside those settings.
Families should explore their state-specific rules carefully because eligibility criteria vary widely across states—and consider consulting professionals who specialize in elder law or financial planning related to long-term dementia caregiving needs[1].
