Since 2004, the median cost for assisted living facilities has doubled; private insurance premiums to cover these costs have tripled.
While nearly 7 in 10 seniors are projected to need daily care assistance, many cite cost as a barrier to access these services.
State and federal policies that reduce upfront or private insurance costs or expand Medicaid coverage can increase access to these services.
For more information, please read our memo on Long-Term Care Insurance Plans.
In 2021, households making between $52,000 and $156,000 annually were classified as middle-income (Pew, 2022). Middle-income seniors are not eligible to qualify for Medicaid long-term services and housing subsidies (West and Dubay, 2019).
Roughly 14 million middle-income seniors will require assisted/independent living community services by 2029, 60% of whom will have mobility issues, 20% will have heavy healthcare needs, and 54% will have financial resource limitations (Pearson, 2019).
Figure 1: Counties with high housing costs for seniors. Shaded Missouri counties have between 20% (dark blue), 20-30% (light blue), and 30-40% (yellow) of seniors (65 and older) who spend more than 30% of their income on housing costs. Data from the Harvard University Joint Center for Housing Studies.
The U.S. Dept. of Housing and Urban Development Section 202 program provides federal funds (up to $175 million in 2022) to nonprofit organizations that offer senior living communities with supportive services (cleaning, cooking, transportation) (HUD, 2022; 2022) or convert housing units into senior assisted living units (HUD, 2022).
Thirty-five percent of individuals in assisted living (often more affluent) enroll in Medicare Advantage (MA) plans, which offer tailored services a patient may anticipate needing (such as wellness programs, medical transportation, vision, dental, or hearing)(Medicare, 2023).
Medicaid is the largest funding source for long-term care (LTC) services (KFF, 2022). While middle-income seniors do not automatically qualify for Medicaid, many states (including MO) have initiated LTC partnerships for Long-Term Care Insurance Plans (LTCIP) holders to qualify for Medicaid coverage once their private policy plan maxes out (James, 2017; NCSL, 2005).
LTCIPs cover the costs of senior living (including nursing homes, home health care, and assisted living) that extend past 100 days after a recent hospitalization that is covered by Medicare (ACL, 2021). Plans can vary significantly in the monthly or lifetime maximum of covered service costs (MO Dept. of Insurance, 2022).
For more information, please read our memo on Long-Term Care Insurance Plans.
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