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Does Medicare Cover Assisted Living In Nj

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What Costs Does Medicaid Cover For Assisted Living

Medicare & You: Nursing Home / Long-Term Care

Medicaid covers some costs of assisted living, but coverage will vary depending on the state where the individual lives because each state has their own rules and regulations. Currently, 46 states offer some form of Medicaid coverage to pay for assisted living costs.

In general, Medicaid may cover assisted living costs including:

  • Long-term care provided by an assisted living facility, nursing home, or home health
  • Occupational, speech, and physical therapy
  • Inpatient and outpatient services

Theres also the Group Adult Foster Care and Supplemental Security Income Assisted Living Benefit that covers assisted living and home-care costs so residents dont have to live in a nursing home. Finally, the Adult Day Health program provides daytime support for seniors.

When Does Medicare Cover Assisted Living

Generally speaking, Original Medicare does not cover assisted living because it is not considered medically necessary skilled care. However, it is very common for Medicare beneficiaries to need assistance with personal care and alternative living arrangements versus living independently at home. Medicares website offers an outline of possible long-term care choices here.

If you reside in an assisted living facility, Medicare will continue to cover services you require, such as hospitalization and medically necessary outpatient care and supplies, but not assisted living expenses.

The Benefits Of Assisted Living

There are many benefits to assisted living. Here are just a few:

  • Peace of mind. Most assisted living communities offer emergency response and security systems campus-wide. If anything should happen to your parent, someone will be there to take care of them. No more worrying in the middle of the night whether theyve fallen or not no more wondering why they arent picking up the phone.
  • Quality care. At an assisted living community, your parent will have the assistance they need as they go about their day, from their first cup of coffee to their nighttime routine. Theyll still have agency to act on their own, but at the same time theyll have help with things such as medication management, bathing, or dressing.
  • Lifestyle options. Of course, your parent is more than their health needs. The assisted living communities of today are focused on offering social activities, cultural programs, group outings, gourmet dining, and even professional entertainment. Residents can be as social as they want and are free to do as they please.

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Free Assisted Living Resources In New Jersey

New Jersey offers numerous free resources for seniors and families who are looking for long-term care for their senior loved one.

Office of Area Agency on Aging Administration

New Jersey is home to 21 county Area Agencies on Aging that develop service systems for adults who are 60 and over. Available services may include information and assistance, transportation, case management, respite care, visiting nurse and legal assistance, among other things.

Shoreview Building, Office 222, 101 South Shore Road, Northfield, NJ 08225

One Bergen County Plaza, 2nd Floor, Hackensack, NJ 07601-7076

Mailing: PO Box 6000, Mount Holly, NJ 08060Physical: Human Services Facility, 795 Woodlane Road, Westampton, NJ 08060

512 Lakeland Avenue, 4th Floor, Blackwood, NJ 08012

Social Services Building, 4005 Route 9, South, Rio Grande, NJ 08242

Administration Building, 800 East Commerce Street, Bridgeton, NJ 08302

900 Bloomfield Avenue, Verona, NJ 07044

115 Budd Blvd., West Deptford, NJ 08096

830 Bergen Avenue, Suite 3B, Jersey City, NJ 07306

4 Gauntt Place, Building 1, PO Box 2900, Flemington, NJ 08822-2900

540 S. Broad Street, PO Box 8068, Trenton, NJ 08650

75 Bayard Street, 5th Floor, New Brunswick, NJ 08901

3000 Kozloski Road, Freehold, NJ 07728

340 West Hanover Avenue, PO Box 900, Morristown, NJ 07963-0900

1027 Hooper Avenue, Building #2, PO Box 2191, Toms River, NJ 08754-2191

930 Riverview Drive, Suite 200, Totowa, NJ 07512

98 Market Street, Salem, NJ 08079

Does Medicare Part B Cover Assisted Living

Does Medicare Cover Long

Medicare doesnt cover assisted living. However, Original Medicare Part B may still cover some medical services that you need, such as outpatient care, and a Part D plan may help with prescription drugs for those in assisted living. In addition to those things, a Medicare Advantage plan may also cover things like dental and vision.

What extra benefits and savings do you qualify for?

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Medicaids Coverage Of Assisted Living In New Jersey

There are three Medicaid waivers in New Jersey, each aimed at helping seniors with different needs, with two suitable for seniors best served in assisted living facilities. The most appropriate is Managed Long-Term Care Services and Supports, which covers medical costs but not room and board. The Program of All-Inclusive Care for the Elderly is primarily for seniors residing at home but can also cover costs if they need institutional care.

Using A Reverse Mortgage To Pay For Assisted Living

An older adult who owns their home outright or has only a small mortgage can convert some of the equity in their home into cash payments while still retaining ownership. While there are different types of reverse mortgages, federally insured Home Equity Conversion Mortgages are the most common. When it comes to paying for residential senior living , reverse mortgages are usually only an option if the institutionalized elders spouse, or another individual who is a co-borrower on the loan, still resides in the home and maintains it per the terms of the loan. Otherwise, the loan becomes due when the last borrower no longer lives in the house for 12 consecutive months, sells the home or dies.

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Other Options For Paying For Memory Care

There are multiple financial resources for those who need help paying for memory care:

  • Insurance: While Medicare is the primary insurance for individuals 65 and older, a retiree may have private insurance through a group plan that covers care for Alzheimers disease and other memory impairments.
  • Retirement benefits: Individual retirement benefits may provide a personal source of payment for dementia and other medical conditions. This includes both individual retirement accounts and annuities.
  • Personal savings: Personal assets may be used to help pay for memory care, including savings accounts, investments and real property.
  • Private organizations: Community organizations, such as a local Alzheimers association, may offer programs to help qualified individuals pay for memory care services. A local church or volunteer group may also offer financial assistance.

Can Social Security Pay For Assisted Living In Your State

Medicaid Financing and Coverage Issues in Assisted Living

In most states, qualifying seniors can use Optional State Supplements to help pay for assisted living costs. OSS is state-based financial aid provided on top of the federal Social Security benefits. As a state-based program, OSS coverage will depend on your location.

In most states, when applicable, OSS can be sent directly to your assisted living community to help pay for the room and board. OSS amounts are calculated based on the individuals income. You can find more information about state OSS benefits here.

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  • Assisted Living Facility In Lakewood New Jersey

    NPI list of 6 assisted living facility registered providers with a business address in Lakewood, NJ, all registered as organizations. A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.


    Medicare Participation

    What is PECOS?

    PECOS is Medicares enrollment and revalidation system and it is the primary source of information about verified Medicare professionals eligible to order or refer healthcare services for Medicare patients.

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    Assisted Living Choices Waiver

    People who are nursing home-eligible and wish to reside in an assisted living facility may qualify for the Assisted Living Choices program. Assisted Living Choices is a Medicaid waiver which allows for 24-hour personal care services to be covered for a limited number of people, helping nursing home-eligible recipients avoid being institutionalized. Other forms of assistance are available through this program, including:

    • Extended prescription drug coverage for non-Medicare residents
    • Periodic nursing evaluations and services
    • Medication oversight and administration
    • Therapeutic, social, and recreational activities

    Who is Eligible?

    Those who require intermediate-level nursing home care are eligible, but individuals requiring skilled care are not. Adults who have no physical disabilities must be 65 or older to qualify.

    • There is a $2,000 asset cap for individuals, and the assets of married couples are considered individually.
    • Only countable assets are considered, including bank accounts, cash, and mutual funds.
    • There is a $2,250 income cap for individuals, with no separately designated amount for couples.

    How to Apply

    Applications can be filed at your local Department of Human Services office, or the process can be initiated over the phone by calling the Choices in Living Resource Center at 801-3435.

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    Other Financial Assistance Options For Assisted Living In New Jersey

    Personal Care Home

    Seniors who are not eligible for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

    How to Apply

    Aid and Attendance

    Learn more and apply online at

    Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

    Reverse Mortgages

    Learn more about your options and how to apply at

    If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home’s equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

    Long-Term Care Insurance

    Learn more about Long-Term Care Insurance and how to apply for a policy at

    Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

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    Does Medicaid Cover Assisted Living In Nj

    I’m not going to hold you in suspense the answer is yes. New Jersey Medicaid does cover assisted living. New Jersey Medicaid also covers in-home care through the same program as well as a couple of others . Medicaid in NJ has undergone some really big changes in the last few years, and they are part of the reason that the programs seem so confusing. The state recently transitioned its care from a state-managed system to one through so-called Managed Care Organizations, which is another way of describing those big health insurance companies that we all know about . The State has also moved back to an income cap structure, which it hadn’t used since the 1990s. You may hear this referred to as global options or the comprehensive waiver program, but the question is the same: What does this all mean?

    How Much Will Medicaid Pay For Assisted Living

    Because Medicaid benefits are defined on a state-by-state basis, its difficult to say exactly how much Medicaid will pay for assisted living. The coverage amount will vary, based on:

    • The state where a senior resides

    • The program a senior is enrolled in

    • The level of care a senior needs

    Still, the majority of state Medicaid programs cover some sort of assisted living cost for residents who meet the eligibility requirements.

    Most qualifying seniors will have access to the following Medicaid assisted living services:

    But, you might be wondering does Medicaid pay for room and board in assisted living?

    The answer to this question can be tricky as well.

    Not exactly.

    Thats because state Medicaid programs cannot directly pay for assisted living room and board. However, several states have optional supplements and assistance programs to help seniors with that expense. These supplements and programs are often administered by either the Department of Human Services or the Social Security Administration .

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    How Much Does Assisted Living Cost In In New Jersey

    Medicare Part D Senior Savings Model

    Figures published in the 2021 Genworth Cost of Care Survey show New Jerseys average fee for assisted living is $6,495 per month, making the state costlier than those that share its borders. Seniors in Delaware typically pay $5,995 for assisted living services, while in Maryland, the average is $4,900. New Yorks typical costs are lower still, at $4,580, while Pennsylvanias $4,100 is the only average fee in the region below the countrys median of $4,500.


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    Let Our Care Assessment Guide You

    Our free tool provides options, advice, and next steps based on your unique situation.

    As many as 6 million eligible Americans either dont apply for or dont use their benefits each year, according to the Centers for Medicare & Medicaid Services. Many factors contribute to this staggering number, notes Letha Sgritta McDowell, an elder law attorney who practices at Hook Law Center in Virginia and North Carolina.

    Its really about comprehending the rules, explains McDowell, who also serves as president of the National Academy of Elder Law Attorneys . Many people dont understand the intricacies of how public benefits work.

    Whether Medicaid and Medicare will help with your family members senior living costs depends on several factors, such as your loved ones age, income, and required level of care. It also depends on communities themselves, as some accept Medicaid as a payment method, while others require private pay.

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    Democratic Egg Harbor City Mayor Lisa Jiampetti, 58, and Republican Hammonton Councilman Joe

    Having Arbor Village also would ensure longtime residents would not have to move out of Smithville if they required assisted living services.

    What happens if the people that are in Smithville, aging in place, and then they have to leave Smithville in order to get care? Jacobs said. So we decided what better place to put a brand new assisted living .

    Mayor Jim Gorman, who attended the groundbreaking, said he believed Arbor Village would benefit the assisted living residents and surrounding businesses.

    Its going to be a great thing for Galloway, Gorman said. Its going to be an economic engine for the Route 9 corridor.

    Windsor Chief Operating Officer Christopher Metternich said the company also planned to offer at-home nursing services to residents in the local community.

    Windsor may also be developing more housing on the site soon. In August 2020, the township Planning Board voted unanimously to authorize construction of eight single-family cottages and an apartment building with 62 market-rate units, as well as the senior-living facility.

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