Does Louisiana Medicaid Pay for Memory Care?

Your parent needs memory care, and the monthly bills will drain their savings in under a year. The natural question — does Medicaid actually cover it? — has a more complicated answer in Louisiana than most families expect.

What Medicaid Does and Does Not Cover

Louisiana Medicaid pays for dementia care in licensed nursing facilities (skilled nursing homes). If your parent meets the clinical and financial requirements, Medicaid covers the full cost of a nursing home stay minus a small patient liability amount calculated from their income.

What Medicaid does not cover is private assisted living. Louisiana licenses senior living communities as Adult Residential Care Providers (ARCPs) at four levels. Levels 1 through 3 — the settings most people picture when they think "memory care" — are not covered by Medicaid reimbursement. Level 4 ARCPs, which can administer medications through licensed nurses, are also private-pay in most cases.

The state does not issue a standalone "memory care" license. Instead, any ARCP or nursing facility that markets a specialized dementia program must register an Alzheimer's Special Care Unit (ASCU) with the Health Standards Section and file a formal disclosure under R.S. 40:1101.

So the practical answer: Medicaid pays for dementia care when your parent is in a nursing facility. If they are in a private assisted living community with a memory care wing, the family pays out of pocket.

The 2026 Financial Eligibility Rules

To qualify for Medicaid-covered nursing home care, your parent must meet both clinical and financial thresholds:

• Countable assets cannot exceed $2,000 for a single applicant. Exempt assets include the primary home (up to $752,000 in equity), one vehicle, household furnishings, and irrevocable prepaid burial contracts up to $10,000 in face value.
• Monthly income cannot exceed $2,982 (the Special Income Limit, set at 300% of the Federal Benefit Rate).

If your parent's income exceeds $2,982, they are not automatically disqualified. Louisiana uses a Medically Needy Spend-Down program instead of Miller Trusts. Under this pathway, excess income is offset by incurred medical expenses — including the projected cost of the nursing facility itself. If those expenses bring the "excess" to zero, your parent qualifies.

The spend-down math works like this: gross monthly income, minus a $20 SSI disregard, minus the $92 Medically Needy Income Eligibility Standard, equals the excess that must be spent down through allowable medical costs.

How to Keep a Parent Home Instead of a Nursing Facility

Many families want to avoid nursing home placement entirely. Louisiana offers two home-based Medicaid programs that serve people with dementia:

Community Choices Waiver (CCW): This Section 1915(c) waiver covers in-home personal care, home modifications, assistive technology, caregiver respite, and personal emergency response systems. The catch is that it's slot-limited — over 11,000 people are on the Request for Services Registry waitlist for roughly 8,000 funded slots. Priority goes to individuals with documented abuse or neglect, ALS diagnoses, or those approved for 32+ hours of LT-PCS who face imminent nursing home placement.

Long-Term Personal Care Services (LT-PCS): Unlike the CCW, this is a Medicaid State Plan entitlement with no waitlist. If your parent meets regular Medicaid eligibility (income under $994/month), agency-directed personal care can begin immediately. Many families use LT-PCS as a bridge while waiting for a CCW slot.

Both programs require the applicant to meet the Nursing Facility Level of Care standard through the LOCET assessment — proving they need the same level of help they would receive in a nursing home.

Spousal Protections When One Parent Needs Care

When only one spouse needs nursing home care, Louisiana applies spousal impoverishment protections that prevent the healthy spouse from losing everything. Louisiana is a "100% CSRA" state, meaning the community spouse can keep up to $162,660 in countable assets automatically — without the half-of-assets calculation used in many other states. The applicant spouse retains $2,000, protecting up to $164,660 combined.

The community spouse also keeps all of their own monthly income. If their income falls below $2,705 per month, they can receive a transfer from the institutionalized spouse's income, up to a ceiling of $4,066.50 with qualifying shelter expenses.

What to Do Next

If your parent has a dementia diagnosis and you're weighing whether Medicaid can help cover their care, the sequence matters: get the clinical evaluation documented, map their assets against the eligibility thresholds, and call Louisiana Options in Long-Term Care at 1-877-456-1146 to start a screening for both CCW and LT-PCS.

The Louisiana Dementia & Memory Care Guide walks through the full Medicaid spend-down calculation, spousal protection worksheets, and waiver application process step by step — including the specific documents you'll need for the BHSF Form 1-L application.

See more Louisiana guides →