Fees, Insurance & Medicaid
The Long Island Alzheimer’s and Dementia Center offers a variety of services, many of which are free to the community. However, to provide the best quality of care to your loved ones, we have a fee for our Social Adult Day Program. The daily rate of Day Program can be paid privately, or possibly through a private long-term care insurance or a managed long-term care plan through Community Medicaid, a New York State program for home and community-based services. Contrary to popular belief, Medicare and many other private insurance plans do not cover the costs of Day Program, so it is important to know what your options are.
COMMUNITY MEDICAID PLANNING FOR AT-HOME CARE AND ADULT DAY CARE PROGRAMS
Long Island Alzheimer's and Dementia Center’s state-of-the-art Day Program is contracted to receive payment through the Community Medicaid program. Community Medicaid encompasses both home care and day care versus institutional Medicaid which refers to skilled nursing facility residential care. Even if you are receiving home care hours through Medicaid, Long Island Alzheimer's and Dementia Center’s Day Program can be included in your approved hours of coverage.
Community Medicaid looks at both income and resources when determining an applicant’s eligibility. To clarify, income is any money that is coming in regularly such as a pension, Social Security or a distribution from an IRA or other retirement account. Resources are assets that the Medicaid applicant has in their name such as checking, savings, money market, stocks, brokerage accounts, bonds, etc. Even if the account is held jointly with another individual, Medicaid counts the total account value towards the resources of the applicant. Currently a single applicant for Community Medicaid cannot have resources in excess of $16,800 and cannot have monthly income in excess of $934 (subject to change per NY State). A married couple who are both applying cannot have more than $24,600 in total resources and their total monthly cannot exceed $1,367 (subject to change per NY State). Do not be discouraged if your income and/or resources are above these Medicaid limits.
Legal techniques such as trusts, life estates and pooled trusts can help you accomplish your goals of qualifying for these benefits. Even if you do not plan on ever seeking nursing home care, it is vital to understand how Medicaid works and seek the professional experience of a Medicaid/Elder Law planning attorney. Failing to do so could result in you being penalized in the future for decisions you make today with the best of intentions, due to set look-back periods. Early planning is the key to preserving your assets, allowing you to make lifetime gifts to family members or to a trust, thereby assuring your assets will not be spent down on the costs of your health care or paid back to the government.
Once you are approved to receive Community Medicaid, you will choose a Managed long-term care (MLTC). Each plan has its own network of providers, including services such as home care agencies, adult day care and other professionals. Long Island Alzheimer's and Dementia Center currently has contracts with MLTC’s Aetna and Agewell (see contact information below). If you have a different MLTC plan, please call your provider to apply for a single-case agreement to cover your loved one’s program expenses.
Find out more about Medicaid eligibility and how this can work for you and your loved ones by clicking here. To find out more about the Long Island Alzheimer’s and Dementia’s Social Adult Program and program fees, call us at 516-767-6856.
The LIAD Center also provides a Counseling Service for those looking for one-on-one care or couples counseling. Our licensed clinical social workers provide psychotherapy for adults and older adults via Telehealth and in-person sessions. Our counseling service specializes in geriatrics, dementia-related issues, caregiver stress, coping skills, grief and life-transitions.
Our counseling services are billable through insurance plans including Medicare, Aetna, Cigna and United Health Care. There are also Out-of-Network options, and sliding-scale self-pay rates available.
For more information about our Counseling Services, call the LIAD Center at 516-767-6856.