Medicaid Spenddown

How to Spend Down in Assisted Living

You are in charge of your parents care.
No one trained you for this job, and it’s not easy.


Are you looking for a home that Dad or Mom can stay in for the rest of their life?  They won’t be down to their last $2,000 for a while.  If it’s less than three years, one must plan.


Some assisted living and small board and care homes are Medicaid certified.  They will accept private pay funds until the resident is approved by Medicaid.  Then the owner is reimbursed by the state/federal government.

The assisted living facility usually requires one to three years of private pay to be accepted. That comes out to be $50K – $150K.  The key is to know where these places are, if there is availability, and if they are capable of taking care of your parents’ needs.  Northern Colorado options are limited, but it can be done.The average cost of assisted living in Colorado is $3700/month.

A full GoCare Assessment includes vital financial questions to help ensure that you understand your parent’s options.

Income, assets, life insurance, long-term care insurance, veterans benefits, and family resources are all part of the puzzle.

Getting the full medical and financial picture is the first step.  If you’re like most children of aging parents, you are, rightfully, confused.  You need guidance in many areas of senior healthcare.

Advantages to Spend Down in Assisted Living

  • Better and more options
  • Your parent gets priority over others already on Medicaid/Innovage
  • You can find an assisted living home that can be your mom or dad’s last.
  • Doctors making rounds at the assisted living homes gives better oversight.
  • A better home means more oversight for your loved one.  Elderly folks need to be seen regularly to detect any new conditions.
  • The peace of mind in having a good place for your parents will give you more time for estate planning and some room to breathe.
  • Smaller board and care homes work with spend down clients.
  • There are wonderful, caring owners who have good models and compassionate care.


At least there is a safety net.

If they are married there is an exemption for the community spouse.

In general, you have to be down to your last $2000 to qualify for Medicaid.  If we live long enough and outlive our money, the government provides all-inclusive care for Colorado residents.


Medicaid patients are required to make their own doctor appointments and manage their own care.  Adult children with aging parents often have to help oversee their care.  The plus side of this is that children get the facts from the doctor and can better advocate.  The down side is that you may be busy with family and career and caring for an aging parent can be STRESSFUL.



HCBS (Home and Community Based Long-Term Services) are available when the Medicaid application has been approved.

PACE (Program for All-Inclusive Care for the Elderly) – PACE coordinates between Medicaid and Medicare.


Innovage is an alternative to Medicaid that is managed care.

The resident still has to meet Medicaid application approval.

Innovage is a non-profit, managed health plan that has been in Colorado since 1990 and is  all-inclusive healthcare in one location.  They offer adult day programs, transportation, in-home services, Alzheimer’s and dementia care, and oversight from case management.

Innovage assisted living partners in the Denver Metro area are more to the south.    The Thornton hub is the most convenient to the North, serving Thornton, Northglenn, Westminster, Arvada, Commerce City, and Federal Heights clients.

Assisted living homes that contract with Innovage are in high demand and timing can be everything to get a loved one placed.

Owners call us with openings!


Upside to Innovage

Managed Care so you don’t have to do as much.
One stop shop for care. It also gets patients out of the home to participate and get good medical attention regularly.

They will still need your advocacy.

Downside to Innovage

Days can be monotonous at times. They go through growing pains.

Memory Care and Spend Down

Alzheimer’s/ Memory care communities/ homes are almost all private pay.

Spend down options occur mostly in skilled nursing facilities that have a locked down section. Spending down will cost $7000-$9000/ month for care. Funds go quickly. There are not many in the state of Colorado.

Your loved one cannot be accepted by Innovage with an Alzheimer’s diagnosis. A new diagnosis, after already being in an approved assisted living, is required.

Medicaid planning is so important to help get your loved one in best home they can stay in and not have to move!


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