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Does Family Care or IRIS pay for room and board at an assisted living community?

Generally, no. CBRF and RCAC care services can be covered through Family Care or IRIS as home-and-community-based supports, but room and board is gene

Quick answer

Generally, no. CBRF and RCAC care services can be covered through Family Care or IRIS as home-and-community-based supports, but room and board is generally not covered by either program -- this should be verified per-placement, not assumed.

HomeQuestionsDoes Family Care or IRIS pay for room and board at a
Answer

Generally, no. CBRF and RCAC care services can be covered through Family Care or IRIS as home-and-community-based supports, but room and board is generally not covered by either program -- this should be verified per-placement, not assumed.

The detail behind the program

This distinction catches a lot of families off guard, because it's easy to assume that if Medicaid is paying for 'the care,' it must be paying for the whole monthly bill. In practice, a resident enrolled in Family Care or IRIS may still be personally responsible for the room-and-board portion of a CBRF or RCAC's monthly cost, funded from the resident's own income (such as Social Security), while the care-services portion is billed to the Medicaid program. Ask both the facility and your Family Care Managed Care Organization or IRIS consultant agency directly, in writing, exactly which costs the program covers for a specific placement before assuming full coverage.

Related questions

Questions families ask

Does Family Care or IRIS pay for room and board at an assisted living community?

Generally, no. CBRF and RCAC care services can be covered through Family Care or IRIS as home-and-community-based supports, but room and board is generally not covered by either program -- this should be verified per-placement, not assumed.

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