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Anyone 55 or older with Medicaid who can live safely at home independently can enroll at a PACE center nearby. According to AARP, most PACE users are 65 or older, and about half live with dementia .
If the facility is licensed as assisted living, Medicaid reimbursement depends on the state’s assisted living provisions. For Medicaid, the costs are equivalent to the traditional Medicaid costs for nursing homes. If the income level is above the Medicaid minimum, there may be a co-pay for residents.
Under an HCBS waiver, states can use Medicaid funds to provide a broad array of non-medical services (excluding room and board) not otherwise covered by Medicaid, if those services allow recipients to receive care in community and residential settings as an alternative to institutionalization. [1]
"Long-term services and supports" (LTSS) is the modernized term for community services, which may obtain health care financing (e.g., home and community-based Medicaid waiver services), [7] [8] and may or may not be operated by the traditional hospital-medical system (e.g., physicians, nurses, nurse's aides).
Assisted living communities are accepting higher and higher levels of care, and nursing homes are becoming a place for those undergoing rehabilitation after a hospital stay or needing extensive assistance. Many assisted living communities now accept individuals who need help with all activities of daily living.
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