Assisted Living in North Carolina

North Carolina is home to roughly 637,800 veterans.^[02] The state provides a range of benefits and resources for veteran residents in need of assisted living services.

The U.S. Department of Veterans Affairs (VA) provides generous benefit coverage to eligible, disabled veterans and their spouses. Many veterans assume they won’t qualify for disability benefits, but many VA benefits’ eligibility criteria are more inclusive than you may think. Also, if you or a loved one acquired a disability during wartime service, additional benefits may apply. See the VA’s list of service-connected ailments to learn more about some qualification requirements. Keep in mind that the list is not exhaustive, and other situations may still qualify.

If you find you need help navigating veterans benefits, or you’re unsure what even qualifies you, you’re not alone — eligibility requirements and the benefits application processes can be quite confusing. Fortunately, North Carolina has many resources available to guide veterans and their families through it, including local VA centers and veterans service organizations (VSOs). VSOs can help veterans and spouses through the entire benefit claim process, especially disabled seniors in need of long-term, assisted living care.

Local VSOs in North Carolina include the following:

• North Carolina Department of Military and Veterans Affairs can connect North Carolina’s veterans and their families with housing assistance, benefits counseling, and claims assistance.
• The American Legion Department of North Carolina provides benefits counseling and claims assistance to North Carolina’s veterans.
• Disabled American Veterans (DAV) Department of North Carolina is another nonprofit organization that provides benefits and claims assistance.
• Veterans of Foreign Wars (VFW) Department of North Carolina provides assistance with filing for disability compensation and counseling for pension and death benefits.

Paralyzed Veterans of America (PVA) has a regional office in the Winston-Salem area. They assist disabled veterans with various legal and medical matters and can provide advocacy to those seeking VA benefits.

Medicaid is a health insurance program for individuals with a low or limited income. It’s a state and federally funded program and is administered at the state level. Medicaid won’t cover the cost of room and board, but it can help families cover some assisted living costs.

NC Medicaid is North Carolina’s state Medicaid program. NC Medicaid covers a range of services, including the following:^[03]

• Cardiac procedures
• Chiropractic services
• Ambulance services
• Clinic services
• Dietary counseling
• Medical equipment
• Hearing aids
• Home health care services
• Hospice, respite, or rehabilitative care
• Inpatient and outpatient hospital services
• Laboratory and X-ray services
• Nursing facility services
• Occupational therapy
• Pharmacy services
• Some behavioral health services

Most people receive their health care coverage through what’s called a “Standard Plan,” which offers physical health, pharmacy, care management, and basic behavioral health services. NC Medicaid also offers a “Tailored Plan” for people who need certain mental health services or have a traumatic brain injury or intellectual/developmental disability.^[04]

Additionally, NC Medicaid offers a few waivers and programs that help more people have access to health care in the community of their choice, like an assisted living facility. The home and community waivers specific to North Carolina include the following:

• NC Innovations Waiver is a federally approved home and community based services (HCBS) waiver program. This waiver is designed to help individuals receive long-term care services within their home or community, as opposed to a hospital setting.
• NC PACE Association is the state’s Program of All-Inclusive Care for the Elderly (PACE). PACE is a Medicaid and Medicare program designed to provide health care coverage to people who meet the state’s long-term care requirements.

Accessing or understanding Medicaid benefits can sometimes feel overwhelming. For free assistance, reach out to a local long-term care ombudsman. You can contact a North Carolina long-term care ombudsman by calling 1-800-662-7030.

Medicare is a federal health insurance program designed for adults aged 65 or older and people with disabilities. While Medicare can help cover some costs of assisted living, it won’t cover the cost of room and board or nonmedical personal care. If you’d like to learn whether a specific procedure, diagnostic test, or medical device is covered, you can search for it using the Medicare coverage search tool.

To help eligible individuals pay for premiums, deductibles, and copays associated with Medicare, North Carolina offers Medicare Savings Programs. For instance, Extra Help is a Medicare program that can help individuals who meet income requirements pay for their Medicare prescription drug costs.

Other Medicare programs in North Carolina include the following:

• NC PACE Association is a Medicaid and Medicare program that provides health care coverage to people who meet the state’s long-term care requirements. It allows those who need nursing facility-level care to remain in their chosen community while receiving care services.
• The North Carolina HIV Medication Assistance Program (HMAP) is run by the NC Department of Health and Human Services. It’s the government-funded AIDS Drug Assistance Program. HMAP helps eligible, low-income people purchase prevention and treatment medications for HIV and related conditions.
• Medicare and Seniors’ Health Insurance Information Program (SHIIP) is administered by the NC Department of Insurance. SHIIP can connect you with benefit counselors who provide assistance with understanding and enrolling in Medicare benefits.

For further assistance with navigating Medicare benefits, reach out to one of North Carolina’s local resources:

• A North Carolina long-term care ombudsman can be reached by calling 1-800-662-7030.
• The Social Security Administration (SSA) Atlanta region serves several locations including North Carolina. Enter your ZIP code into the Social Security Office Locator to find an office near you.