Many people assume that the medical assistance benefits for nursing home facilities also apply to assisted living facilities. This is not the case. The only medical assistance programs that include payments for assisted living facilities is the Elderly Waiver Program.
The Elderly Waiver Program does not pay for room and board. The Group Residential Housing (“GRH”) Program does pay for room and board in assisted living facilities, but only for low-income individuals. The gross income limit for GRH is $867 a month. GRH is a cash assisted program for low income individuals. A separate application must be submitted to apply for GRH benefits. The asset limit for GRH is $2,000.
If the person has gross income less than $2,163 per month the person will qualify for the EW Special Income Standard, and will be allowed to keep $970 in monthly income to apply to rent and personal needs. The person will be allowed to keep $95 for personal needs and the rest of the monthly income $875 will be applied to room and board charges. If the person’s gross monthly income exceeds $2,160, the person is only allowed to keep $730 of income per month to apply to rent and personal needs.
This is compared to medical assistance benefits to pay for care in skilled nursing facilities which covers room and board charges. In 2013, the average monthly payment for medical assistance recipients was $4,268. The statewide average nursing facility daily rate was $177.82.
Given the room and board charges, a person may be better off seeking admission to a skilled nursing home.