The Cost of Memory Care in North Carolina
The Cost of Memory Care in North Carolina
Note: Memory care is typically available in a residential setting, such as a living assisted facility. The rates for memory care tend to be 20%-30% above the cost for assisted living. There is currently no national database tracking memory care costs in the United State, so we’ve estimated those monthly costs listed below by adding 25% to the rates listed in Genworth’s 2021 Cost of Care Survey.
At $5,013 per month, North Carolina’s average memory care rates are very similar to costs in neighboring Tennessee. Costs in South Carolina are nearly $500 less expensive, with its memory care rates averaging $4,515. Seniors living in Virginia can expect to pay $1,550 more per month than in North Carolina.
$5013: North Carolina
$5625: The United States
$6563: Virginia
$5131: Tennessee
$4515: South Carolina
Memory care rates within North Carolina can vary depending on the geographical area. Residential memory care costs can be as low as $3,750 per month in Fayetteville and as high as $6,735 in Raleigh. Costs for similar types of care in Hickory average $4,404 per month, and to the south in Wilmington, rates are $6,568. In Greenville, seniors’ costs for memory care average $5,766, and in New Bern, the costs per month are $4,556.
$3750: Fayetteville
$6735: Raleigh
$4404: Hickory
$8568: Wilmington
$5766: Greenville
$4556: New Bern
A variety of long-term care services, in addition to memory care, are available throughout North Carolina. Some of those services and their average costs range from the lowest of $1,197 for adult day health care to $4,385 for either homemaker services or home health care. Assisted living facility median costs in the state are $4,010, and nursing home rates are $7,483 for a semiprivate room and $8,213 for a private room.
$1197: Adult Day Health Care
$4385: Homemaker Services
$4385: Home Health Aide
$4010: Assisted Living
$7483: Nursing Home (semiprivate)
$8213: Nursing Home (private)
Does Medicaid Cover Memory Care in North Carolina?
Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in North Carolina.
Medicaid in North Carolina does pay for some of the costs of memory care through the state’s Personal Care Services program. Available to seniors living in adult care homes that are state-licensed, this program provides assistance to Medicaid recipients who are elderly, disabled and have a cognitive impairment. An independent assessment and financial eligibility for Medicaid coverage are required.
What Memory Care Services Are Covered by Medicaid in North Carolina?
Seniors eligible for the Personal Care Services program can receive up to 130 hours of assistance per month with their everyday care tasks. These services are for individuals who are either living in a:
- Private home
- State-licensed residential care home
- Combination home
- Group home that is a supervised living facility
Qualifying tasks can include dressing, toileting, bathing and other activities of daily living.
How to Know If You’re Eligible for Medicaid in North Carolina
In North Carolina, you must meet certain medical, financial income and asset requirements to obtain Medicaid and help in paying for long-term care. To qualify for Medicaid, you must:
- Be a full-time North Carolina resident
- Be a U.S. citizen or have legal immigration status
- Be age 65 and up or blind or disabled with a qualifying disability consistent with the level of care being requested
- Have a monthly combined income that is no more than 100% of the federal poverty rate — although Medicaid will cover care costs for medically needy applicants whose income exceeds these rates
Have assets totaling $2,000 or less if single, with $3,000 allowed for married couples with both individuals requiring care
2022 Medicaid Income Limits for Seniors in North Carolina
Single Applicant:
Income Limit (per month): $1,074
Asset Limit: $2,000
Two-Person Household (Only One Person Applying)
Income Limit (per month): $1,452
Asset Limit: $3,000
Two-Person Household (Both People Applying)
Income Limit (per month): $1,452
Asset Limit: $3,000
When only one spouse is applying for Medicaid, only the income of the applicant is counted. The non-applicant spouse can apply for a Minimum Monthly Maintenance Needs Allowance of between $2,177.50 and $3,435 per the state’s spousal impoverishment rule.
Assets include cash, investments, IRAs, savings accounts, checking accounts and real estate but not the primary home. A 60-month look-back period applies for checking past asset transfers that may incur a penalty period of Medicaid ineligibility.
Seniors who do not meet the eligibility requirements for Medicaid can qualify in different ways. For example, the Medically Needy Pathway provides Medicaid coverage to low-income individuals, including the elderly, by allowing them to spend their excess income on medical expenses so they can become financially eligible.
How to Apply for Medicaid in North Carolina
In North Carolina, you can apply for Medicaid online through the website, North Carolina ePASS. Written applications can be picked up at a local Department of Social Services office. Beneficiaries can also apply by calling the Medicaid Managed Care Call Center at (833) 870-5500 or through the mobile app available on Google Play or through the App Store.
Seniors needing memory care assistance can apply for the Personal Care Services Program by visiting their primary care physician who will fill out and forward an independent assessment request for personal care services to the North Carolina Department of Health and Human Services designated assessment agency, Liberty Healthcare Corporation.
Information You Will Need
When you apply for Medicaid in North Carolina, you need to provide proof of income over the past 5 years in addition to bank and other financial statements. You must provide government-issued identification, your Social Security card and citizenship proof. You may also need to show:
- Copies of titles to your real estate and/or automobile
- Copies of any burial or pre-paid funeral arrangements
- Copies of other types of insurance and health care policies
Seniors who already are Medicaid beneficiaries and are applying for memory care benefits through the Personal Care Services program must:
- Have their physician complete the appropriate form requesting these services
- Be assessed by a Liberty Healthcare Nurse Assessor at your home, using a specific screening tool to determine your medical and care necessities and abilities
- Be approved for services; if not approved, the decision can be appealed
How to Get Help Applying for Medicaid
Seniors who need help applying for Medicaid in North Carolina can contact the Department of Social Services or go on the NC ePASS website or app. Help can also be obtained through Legal Aid of North Carolina and the Division of Aging and Adult Services.
Division of Aging and Adult Services
(919) 855-3400
Area Agencies on Aging are located throughout the state to provide seniors with advocacy, program information and other needs.
North Carolina Senior Legal Helpline
(877) 579-7562
Affiliated with Legal Aid of North Carolina, counselors at this helpline are available to provide seniors with information, help and referrals to others who can assist with issues pertaining to Medicaid and other public benefits.
(800) 662-7030
Seniors can contact the North Carolina Department of Health and Human Services to find a senior center in their community that provides numerous services, including legal assistance and health insurance counseling.
(877) 201-3750
Agents at this ombudsman program help seniors with information about the state's Medicaid program and provide referrals to community services.
Does Medicare Cover Memory Care in North Carolina?
The short answer is that no, Medicare does not cover the cost of memory care in North Carolina. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
Other Financial Assistance Options for Memory Care in North Carolina
Seniors who are not eligible (due to location, financial situation, or other factors) 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 Memory Care affordable.
Aid and Attendance
Learn more and apply online at va.gov.
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 Memory Care.
Reverse Mortgages
Learn more about your options and how to apply at ftc.gov
If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. 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 (LTC) Insurance
Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.
Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. 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 Memory Care will not typically be eligible to sign up for a LTC insurance policy.
Free and Low-Cost Resources for Seniors in North Carolina
Some free and low-cost resources are available to North Carolina seniors needing memory care services. The support services below can help with finding memory care or other necessary services.
(800) 272-3900
Two chapters of the Alzheimer's Association are located in North Carolina. These include the Eastern North Carolina Chapter, with its office in Raleigh, and the Western Chapter, which has offices in Charlotte and Greensboro. Both provide advocacy, events, education and support to seniors and their families affected by this disease.
North Carolina Division of Aging and Adult Services Transportation
Call individual locations as listed
Local services are provided, including transportation to nutrition sites, senior centers, drug stores, shopping and recreational spots. Medical transport helps seniors get to doctors' offices, health clinics and hospitals. Each county has its own transit services and contact numbers to call.
Ombudsmen help seniors with a variety of issues relating to long-term care. Notably, ombudsman assist seniors and their families solve conflicts between themselves and the long-term care facility. They make sure residents know their rights and the facility’s responsibilities.
North Carolina’s Area Agency on Agency is dedicated to addressing the needs of older adults at a regional level. It provides information and services that allow seniors to choose the best possible living arrangement for them.
Memory Care Laws and Regulations in North Carolina
In North Carolina, residential facilities serving individuals with dementia or Alzheimer’s disease must be licensed as special care units. These facilities are overseen by the North Carolina Division of Health Service Regulation’s Adult Care Licensure Section. The agency has specific regulations about staffing as well as the type of services that are provided.
Scope of Care
Licensed facilities that provide memory care must have a detailed written mission statement describing the community’s philosophy and qualifications for caring for individuals with Alzheimer’s disease or other special needs.
Care Plans
Long-term care communities must create personalized care plans within 30 days after admission. Assessments must be performed within 72 hours after admission or within 10 days following a significant change in health. Otherwise, care plans must be reviewed annually.
Medication Management
Assisted living facilities can help residents self-administer medications. Staff members must complete appropriate training and be overseen by a licensed nurse who has been trained to follow the agency’s plan of care.
Staffing
Memory care units must have at least one staff member for every eight residents during the day and evening and at least one staff member for every 10 residents at night. Facilities must employ full-time care coordinators, and the state also has requirements for training and continuing education.
Medicaid Coverage
North Carolina Medicaid will pay for a variety of residential and community-based long-term care services through optional waivers. Residents must meet financial eligibility criteria and require a nursing home level of care based on their need for assistance with daily activities, such as bathing and dressing.
Reporting Abuse
Industry professionals in North Carolina must report suspected abuse to the Health Care Personnel Registry Investigations Branch within 24 hours of the incident. Abuse, neglect, exploitation and other forms of harm, such as chemical restraint, can be reported online, by phone, by mail or by calling (919) 855-3968.
Frequently Asked Questions
How much does memory care cost in North Carolina?
Memory care in North Carolina costs an average of $5,000 per month, which is slightly lower than the U.S. median. This type of care is more affordable than skilled nursing, but it costs 20 to 30% more than conventional assisted living due to state-specific requirements related to staffing, security and activities.
Are there financial assistance programs for memory care in North Carolina?
Yes, North Carolina does pay for memory care through its Special Assistance Special Care Unit Program. This supplemental benefit provides up to $1,500 per month. Benefits are designed to help low-income seniors and disabled adults who are unable to afford the services that they require from a Special Care Unit. Benefits cover room and board, and additional programs can help with the cost of personal care.
Does Medicare pay for memory care?
Medicare does not pay for memory care or assisted living, but it will pay for hospice care provided in residential facilities. Other covered services include cognitive assessments, home safety evaluations and care planning. In most cases, North Carolina residents must turn to the state’s Medicaid program or purchase private long-term care insurance to receive help paying for memory care provided outside of a private home or skilled nursing facility.
What are activities of daily living?
Activities of daily living, also called ADLs, are a group of essential everyday tasks, including bathing, dressing, grooming, meal preparation and ambulating. Individuals who need assistance with multiple ADLs may qualify for a nursing home level of care, which could entitle them to additional benefits through Medicare or Medicaid.
What is the difference between memory care and assisted living?
Memory care and assisted living are similar in many ways. Both facilities provide housing, meals and scheduled activities. However, in a memory care community, all aspects of care are tailored to individuals with cognitive impairments. Staffing and training requirements are higher, and facilities are equipped with advanced security features to prevent wandering and other potentially dangerous behaviors.
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