My mom has no savings, but needs assisted living. Are Social Security and Medicaid enough?

Older adults in the U.S. are sounding the alarm on their concerns about the healthcare system. The John A. Hartford Foundation reports that 56% of older adults say it is difficult and stressful to navigate the health care system, and 62% believe health insurance plans come with too many confusing choices (1). Moreover, misinformation about health care coverage abounds.

Consider this scenario: You've witnessed the start of a decline in your mother's cognitive health and ability to care for her own needs, but neither you nor your family are able to care for her around the clock.

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Your first inclination might be that Medicare will help cover the costs, and you wouldn't be alone. The Kaiser Family Foundation found that 55% of U.S. adults believe Medicare will cover a long-term stay in a nursing home, which is not the case (2).

Despite this lack of coverage, most older adults will require this kind of care. A 2019 study from the government Office of the Assistant Secretary for Planning and Evaluation found that 70% of adults who live to age 65 will need some Long-Term Services and Supports (LTSS) before they die (3). Older adults with fewer financial resources are more likely to need this kind of care.

More recent, non-government research backs this up, too. Northwestern Mutual's most recent Planning and Progress Study found that 61% of American adults expect to need long-term care (4). What's more, 74% would prefer to receive that care at home, not a nursing facility.

In your situation, there isn't a choice: It's time to move mom into an assisted living facility, but she has no retirement savings that you know of, and currently gets by on a small Social Security check.

How can you best keep your mom comfortable for the final years of her life?

While her finances may ultimately dictate what kind of facility she moves into, it's worth making an effort to respect her wishes by seeing whether she can afford a nicer place.

Consider a thorough search for long-forgotten assets. Even if you're mostly certain that your mom doesn't have substantial savings, it's worth trying to find out if she has any inactive financial accounts. According to a 2023 report by financial firm Capitalize, nearly 30 million 401(k) accounts worth $1.65 trillion were left behind by American workers who may have forgotten about them during job moves (5).

You can search for these types of accounts using the U.S. Department of Labor's Lost and Found Database (6). If she suffers from cognitive impairment, accessing these funds could be tricky and require you to obtain legal authority, such as through guardianship.

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If a lavish facility is off the table after searching for lost funds, the focus should become your mother's safety and ensuring her daily needs are met.

Medicaid generally does not cover room and board costs at an assisted living facility. However, many assisted and independent living facilities accept Medicaid Home and Community-Based Service Waivers that can cover some costs (7). Nonprofit or church-affiliated facilities may offer support as well.

You might also decide to bite the bullet and chip in to pay for a private facility. The median cost of an assisted living facility is nearly $6,100 a month, according to SeniorLiving.org. Prices can vary based on location, level of care, and length of stay (8).