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Paying for Assisted Living in Utah

Medicare, Insurance, Medicaid & the New Choices Waiver

One of the most common questions families ask is:

“How do people actually pay for Assisted Living?”

The answer can be confusing — especially with Medicare, insurance plans, and Medicaid all sounding similar. This page is designed to clearly explain the differences, outline Utah’s rules, and help families plan with confidence.

Medicare (A Common Misunderstanding)

Medicare is health insurance — not long-term care coverage.

Medicare helps pay for
  • Doctor visits and hospital stays
  • Short-term rehabilitation after a hospital stay
  • Hospice care
  • Limited home health services
Medicare does NOT pay for
  • Assisted Living
  • Long-term custodial care
  • Ongoing help with daily activities (bathing, dressing, medications)

Bottom line: Medicare does not cover Assisted Living or long-term care.

What About Insurance or Supplemental Plans?

Many families assume that private insurance, Medicare supplements, or employer retirement plans help pay for Assisted Living. In most cases, they do not.

Typically NOT covered by standard insurance plans
  • Assisted Living
  • Memory Care
  • Long-term personal care
  • Room and board in senior living

Long-Term Care Insurance (If You Have It)

Some individuals have Long-Term Care (LTC) insurance, which may help pay for Assisted Living.

Important things to know:

  • Coverage varies by policy
  • Benefits often require a care assessment
  • Daily benefit limits may apply
  • Elimination (waiting) periods are common

If you have Long-Term Care insurance, we strongly recommend:

  • Reviewing your policy early
  • Contacting your insurance provider
  • Asking how Assisted Living benefits are triggered

Long-Term Care insurance can be very helpful — but it must be planned for before care is needed.

Medicaid (The Foundation for Government Assistance)

Medicaid is a state and federally funded program that helps individuals with limited income and assets pay for health and long-term care services.

In Utah
  • Many people qualify after spending down savings
  • Medicaid alone does not automatically pay for Assisted Living
  • Special programs called waivers are required

The Utah New Choices Waiver

Help Paying for Assisted Living Care

The New Choices Waiver is Utah’s primary Medicaid program that helps pay for care services in Assisted Living for people who qualify.

The Waiver may help pay for
  • Assistance with daily activities (ADLs)
  • Personal care services
  • Medication management
  • Ongoing support in Assisted Living
The Waiver does NOT cover
  • Room and board (housing costs)
  • Private extras outside the approved care plan

👉 Link to Utah Medicaid – New Choices Waiver website

⚠️ Very Important Utah Eligibility Requirement

The New Choices Waiver is not an immediate entry program for Assisted Living.

To qualify, one of the following must apply:

Option 1: Private Pay First
  • The individual lives in Assisted Living and pays privately for a minimum of 12 months

After that time, they may qualify for the Waiver if:

  • Financial eligibility is met
  • Care needs qualify
Option 2: Skilled Nursing Pathway
  • The individual first enters a Skilled Nursing Facility
  • Stays at least 90 days
  • Qualifies financially for Medicaid
  • May then transition into Assisted Living with the Waiver

Why this matters:

The Waiver is designed to support individuals who would otherwise need nursing home care — not for immediate Assisted Living placement.

Early planning protects future options.

Why This Matters When Choosing an Assisted Living Community

Many Assisted Living communities in Utah do NOT accept the New Choices Waiver.

  • Residents may need to move when funds run out
  • Families face unexpected transitions
  • Care continuity is disrupted

🌼 BeeHive Homes of St. George Accepts the New Choices Waiver

BeeHive Homes of St. George proudly accepts the Utah New Choices Waiver, and we plan for it intentionally.

What this means for families:

  • Long-term planning, not short-term placement
  • Reduced risk of forced relocation
  • Experience supporting waiver transitions
  • A home-like Assisted Living environment — not a nursing home

We believe residents deserve stability, dignity, and a place they can truly call home.

Need Help Understanding Your Options?

This system is complex — and you don’t have to navigate it alone.

We’re happy to:

  • Explain payment options and timelines
  • Discuss private pay, insurance, and waiver planning
  • Help you understand next steps, even if you’re just starting
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