Illinois HCBS Medicaid Waiver for Supportive Living Facilities - Financial Support for Assisted Living

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers," which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.

Waiver Description

Illinois’ Supportive Living Program provides financial assistance to state residents to help pay for the cost of assisted living. The term “Supportive Living” in the program’s title applies broadly and includes assisted living, board and care homes and recently, residential memory care (for persons with Alzheimer’s or dementia). Program participants must be qualified for nursing home care and choose to receive that care in an assisted living environment. The residence provides all the individual's personal care needs and but does not pay for room and board costs. Individuals are permitted to retain approximately $90 per month as a personal needs allowance.

The Supportive Living Program is an Illinois Medicaid program. To avoid confusion, it is worth mentioning that the program is formally referred to as the 1915c Home and Community-Based Services (HCBS) Supportive Living Program waiver.

 Participation in this waiver prevents participation in other Illinois Medicaid Waivers such as the Waiver for the Elderly.

Eligibility Guidelines

One must meet the age, financial and functional requirements in order to receive the benefits. For elderly applicants, it should be noted that the following guidelines are not comprehensive, but a good guide. To qualify for this waiver, the applicant must be at least 65 years of age and an Illinois resident. If younger than 65, they must be declared disabled by the Social Security Administration. In addition, they must be assessed and found needing of nursing home level care. Finally, they must be financially qualified for Medicaid, which, in Illinois, is also referred to as the Medical Assistance Program.

2017 Supportive Living Program Income Limits
For an individual applicant, monthly gross income cannot exceed $1,005 or annually, $12,060. For married couples, the limit is $1,353 per month or $16,236 annually. However, if one spouse is applying for assistance from Medicaid and the other is not, then some of the applicant's income can be separated from the non-applicant spouse's income to help the applicant become financially compliant.

2017 Supportive Living Program Asset Limits
The Medicaid asset limit for a single applicant is $2,000. For a married couple, the limit is $3,000, except if one spouse is applying for Medicaid and the other is not. In 2017, in this split-spouse situation, the non-applicant can retain up to $109,560 in assets. Certain assets and property are exempt from the Medicaid accounting of net worth, including the home, a car, and personal property such as furniture and jewelry. Note that the home is only considered an exempt asset if the homeowner lives in the home and the value of their home equity does not exceed $560,000.

Options for Individuals Exceeding the Limits
For individuals whose income or assets exceed the limits, there are two options that can help them qualify for Medicaid. Illinois offers Medically Needy Medicaid, which is for persons with very high medical expenses. This program looks at both their medical expenses and their income. If it is determined they cannot afford their care requirements, then they will qualify for some Medicaid assistance.

Another option is to work with a Medicaid planning professional to re-structure one's assets and income so that one meets the eligibility requirements. Assets over the limit can be converted from "countable assets" to "exempt assets." This option has the additional benefit of helping families maintain some of their financial resources for future generations. Find assistance applying for Medicaid.

 

Benefits and Services

The Supportive Living Waiver provides for a variety of services appropriate for individuals residing in assisted living environments. Applicants are assessed individually and the services for which they are eligible are determined. These can include:

  • Personal care - assistance with the activities of daily living such as bathing and grooming
  • Medication administration - supervision and assistance taking prescription drugs
  • Chore services - laundry, housekeeping and other instrumental activities of daily living
  • Social, recreational and physical activities - provided in or by the supportive living community
  • Personal emergency response (PERS / Medical Alert devices and services)
  • Skilled nursing - on a temporary basis only

The Support Living Program does not cover the participant’s room and board expenses. Participants are expected to pay for those expenses using Social Security or Supplemental Security Income. Within limits, family members are also permitted to supplement their loved one’s expenses.

 

How to Apply / Learn More

This program is available to seniors statewide; however, not every county has approved supportive living facilities. Participants may be required to move to a county other than their own to receive care. A list, by county, of approved facilities is available here.

To apply for this waiver, interested individuals should contact the Department of Healthcare and Family Services (HFS), Bureau of Long Term Care

Did You Know? Free assistance is available to help Illinois seniors find affordable assisted living residences and also specialized memory care homes. Get help here.