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Memory Care in North Carolina
North Carolina, a state that’s becoming increasingly attractive to retirees because of its low cost of living, is home to 10,698,973 people, with 17% of them over the age of 65. Alzheimer’s disease affects 180,000 seniors in the state, a figure that’s expected to grow by 16.7% in only five years. According to the CDC, the death toll from the disease rose by 16.41% between 2016 and 2020. To respond to this, the state has committed to increasing resources and support for people who live with Alzheimer’s through the Dementia-Capable North Carolina plan.
Throughout North Carolina, dementia care communities preserve the health of residents with Alzheimer’s. These communities have caregivers trained in geriatrics and dementia who help residents manage their personal wellness on a daily basis. Memory care also employs research-informed techniques to preserve cognition and improve mood. In addition to connecting seniors with important resources, this guide explores the cost of memory care in cities across North Carolina.
The Cost of Memory Care in North Carolina
When trying to decide how to pay for memory care, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of memory care in North Carolina and its 36 cities.
The Cost of Memory Care in North Carolina's Top Cities
The cost of memory care in North Carolina varies between cities. In Raleigh, it's less than the state average at $5,259 per month, whereas it's slightly more expensive in Charlotte and Greensboro at $6,224 and $6,855. Cary represents the upper limit for North Carolina, with monthly memory care costs averaging $9,985.
North Carolina
$5,905
Charlotte
$6,224
Greensboro
$6,855
Cary
$9,985
Raleigh
$5,259
Inflation's Impact on the Cost of Memory Care in North Carolina
Like the rest of the U.S., inflation's effect on memory care costs in North Carolina is expected to continue its upward trend. From 2022 to 2023, the cost of memory care rose 27.4% in the state, nearly triple the 10.4% nationwide average. All neighboring states have experienced inflation in the same timeframe, but at a lower rate. Kentucky and Virginia saw an increase in memory care costs of 11.3% and 7% respectively. South Carolina and Georgia had inflation rates at nearly half the national average, at 5.6% and 4.5% respectively.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| North Carolina | $4,636 | $5,905 | $5,978 |
| U.S. Average | $4,863 | $5,369 | $5,792 |
| South Carolina | $4,011 | $4,234 | $4,881 |
| Virginia | $5,298 | $5,667 | $6,060 |
| Kentucky | $4,359 | $4,852 | $4,784 |
| Georgia | $4,016 | $4,196 | $4,157 |
The Costs of Other Types of Senior Living
The cost of memory care is $2,851 higher than the cost of independent living and $1,077 higher than assisted living in North Carolina. Nationwide, memory care costs $2,374 more than independent living and $910 more than assisted living. Factors including specialized memory care services, a higher staff-to-resident ratio, and care-specific amenities contribute to the difference in price between memory care and other senior living arrangements.
Assisted Living
$4,828
Memory Care
$5,905
Independent Living
$3,054
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 Basic Medicaid Income Limits for Seniors in North Carolina
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $14,580 | $2,000 | |
| Two Person | 1 | $14,580* | $2,000 | $148,620 |
| Two Person | 2 | $19,728 | $3,000 |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
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 $2,465 and $3,715.50 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.
| Program | Contact | Services provided |
|---|---|---|
| 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. |
| Senior Centers | (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. |
| Medicaid Ombudsman | (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.
For more information about when Medicare can be used to pay for Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in North Carolina.
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.
| Name | How To Apply | How It Works |
|---|---|---|
| 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
There are many resources in North Carolina that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Area Agencies on Aging | There are 16 Area Agencies on Aging (AAA) in North Carolina. Their primary responsibilities typically fall within five categories: program and resource development, advocacy, information brokerage, planning and funds administration quality assurance. Contact information for each AAA location, along with the names of the respective counties they serve, is available on the NC Department of Health and Human Services website. |
Cash Assistance Programs
Cash assistance programs in North Carolina provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, North Carolina seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Money Follows the Person | 855-761-9030 | Although it's not one of North Carolina's Medicaid waivers, the Money Follows the Person program is typically used in conjunction with waiver services. It enables those who are living in institutional facilities to move back home or into a community setting to receive supportive services via waiver programs. Participants receive priority access to home- and community-based services, as well as extra funding, to enable a successful transition. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help North Carolina seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Congregate Nutrition Sites | Nutrition sites provide hot meals to seniors in a communal setting. Generally served at lunchtime, meals contain one-third of an adult's daily recommended nutrition. Congregate dining often takes place within senior centers, where older adults can also join an array of enrichment and social activities. | |
| North Carolina Meals on Wheels | North Carolina Meals on Wheels provides seniors across the state with nutritious meals, friendly visits and safety checks. This food assistance program is open to older adults ages 60+. Those mobile enough can enjoy healthy meals in a congregate setting at their local senior center, while those with qualifying mobility issues may receive home delivery. Meals are provided on a sliding-scale basis, ranging from no price to full cost depending on personal circumstances. | |
| North Carolina Seniors Farmers' Market Nutrition Program (SFMNP) | 800-662-7030 | The North Carolina Seniors Farmers' Market Nutrition Program (SFMNP) is open to older adults residing in one of the 45 counties in which the program is active. They must also fall within the current year's specified low income level. Coupons are issued to eligible participants to use at local farmer's markets for buying fruits and vegetables. The coupons are not valid on additional items at farmer's markets, such as jams, honey or baked goods. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in North Carolina collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Assistive Technology Program | The North Carolina Assistive Technology Program operates statewide, with centers in Raleigh, Charlotte, Greensboro, Greenville, Sanford, Wilmington, Sylva, Morganton and Winston-Salem. Individuals can borrow diverse equipment for testing purposes, with loans typically available for a few months. |
Health Insurance & Prescription Drug Coverage for Seniors
North Carolina seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Drug Card | The free North Carolina Drug Card is the statewide prescription assistance program. Available to all residents of North Carolina, it provides significant discounts on the cost of prescription medications at participating outlets. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in North Carolina have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Section 504 Home Repair Program | Administered by the U.S. Department of Agriculture, the Section 504 Home Repair Program gives grants and loans to low-income homeowners. Older adults who live in certain areas may be eligible for a grant of up to $10,000 to make their property safe. | |
| North Carolina Weatherization Assistance Program | The Weatherization Assistance Program is available to low-income households across North Carolina, with a priority given to seniors and other vulnerable individuals. Free services include educating people about energy efficiency and home safety, evaluating homes and performing tests, repairing and replacing inefficient heating and air systems, insulating properties and fitting smoke and carbon monoxide detectors. |
Legal Resources
Many organizations offer free or low-cost legal services to North Carolina seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Long Term Care Ombudsman | 828-485-4213 | The North Carolina Long Term Care Ombudsman program provides advocates that help protect the rights of seniors who reside in nursing homes, assisted living facilities and similar shared communities. Long-term care ombudsmen investigate complaints about quality of care, resolve conflicts regarding services or benefits and help educate seniors and their loved ones about their rights. Each North Carolina county has a dedicated Community Advisory Council that works alongside LTC ombudsmen to ensure that local adult care homes are appropriately run. |
| North Carolina Senior Law Project | 877-579-7562 | The Senior Law Project provides free legal assistance to seniors aged 60 and older. Seniors can call the toll-free line for help with wills and powers of attorney, public benefits, consumer issues, housing issues and concerns related to elder abuse or neglect. |
Senior Centers
Senior centers in North Carolina bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Division of Aging and Adult Services | 919-855-3400 | The Division of Aging and Adult Services provides a network of community-based senior programs and benefit opportunities across the state. Seniors can access information about health insurance, housing, senior rights protections, the ombudsman program and other support services. |
Social Security Offices
Social Security offices in North Carolina help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several North Carolina resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Homestead Exclusion Program | 877-252-3052 | Through the North Carolina Homestead Exclusion Program, seniors aged 65 years and older who meet income eligibility requirements can apply for property tax exemptions by excluding a portion of the appraised value of their permanent residence. Income includes Social Security benefits, retirement income, interests, dividends and proceeds from insurance. Honorably discharged disabled veterans or their unmarried surviving spouses are also qualified for the homestead exclusion program. New applicants may complete the necessary form and submit it to the local tax office. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. North Carolina retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina Low Income Energy Assistance Program (LIEAP) | 800-662-7030 | The federally funded Low Income Energy Assistance Program (LIEAP) provides one-time payments to eligible households to help pay for their heating services. |
Veteran's Services
North Carolina retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| North Carolina VA Benefits and Health Care | The North Carolina VA Benefits and Health Care's Regional Office is in Winston-Salem, and nine Vet Centers throughout the state further support former members of the U.S. Armed Forces. Senior veterans can receive care at four VA Medical Centers in Durham, Asheville, Salisbury and Fayetteville. Seven outpatient clinics offer specialized services such as dialysis and rehabilitation, and individuals may also visit 20 community outpatient clinics. The North Carolina VA operates four veteran cemeteries in Raleigh, Salisbury, New Bern and Wilmington. |
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.
| Topic | Rule |
|---|---|
| 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. |
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