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Section 3: Options for Paying for Care

  • Medicare & Senior Living Communities: Medicare generally does NOT cover care in a senior living community. However, Medicare will cover 20 full days and 80 partial days of SNF care per year IF a person was hospitalized for 3+ days prior to admission and the physician certified that SNF care is required. SNF placement should be directly from the hospital or within 30 days of discharge. Medicare Advantage plans may have different requirements, so it’s important to check your loved one’s plan if they have it.
  • Medicare & Home Care: Similarly, Medicare only covers home care services if the physician certifies that the person is homebound and requires “skilled services.” Example of these include administration of intravenous antibiotics, complex wound care, or physical therapy. Most often, these services are provided for a brief period of time following a hospitalization. Medicare does not cover home care services for chronic needs such as taking medications or bathing.
  • Medicaid & Senior Living Communities: Medicaid will cover SNF care for those who are financially eligible, assuming the facilities accept Medicaid. Some Assisted Living Facilities will accept Medicaid for services provided, but will not cover fees for room and board. Connecticut has varying levels of Medicaid eligibility as well as options for “spending-down” assets to become Medicaid-eligible. We recommend speaking with an eldercare attorney to determine the best option for the person living with dementia.
  • Medicaid & Home Care: Medicaid will cover home care services for both skilled and chronic needs in Connecticut, including adult day services. The amount of home care services provided is determined by a formal assessment of the patient’s care needs.

You can find out more about eligibility requirements for Medicaid-reimbursed services by calling the Area Agency on Aging at 1-800-994-9422 or visiting their website.

  • Long-term care (LTC) insurance: are policies that specifically cover senior living communities, including SNFs and Assisted Living, as well as home care services. The state of Connecticut offers a 5% discount if LTC insurance is used to pay for SNF care. However, you cannot purchase a plan after a dementia diagnosis. If you currently have LTC insurance and plan to use for memory care within a senior living community, be sure that the LTC plan covers dementia care. The National Council on Aging offers more information.
  • Veteran Administration (VA) Services: If your loved one is a Veteran, the VA also has programs that provide and pay for both long-term care services. You can find out more about those services on their website.