31 Assisted Living Communities in Buncombe County, North Carolina

The average cost of assisted living in the county is $4,491 per month. This guide is a starting point covering the cost of assisted living care in the county, as well as financing options to pay for it. You’ll find in-depth information on 31 Assisted Living Communities in Buncombe County and several in surrounding areas. The Cost of Senior Care in Buncombe County, NC

• Assisted Living: $4,491
• Nursing Home Care: $7,680
• In-home Care: $3,909
• Adult Day Health Services: $1,083

Genworth’s 2018 Cost of Care study documents monthly senior care costs throughout the country. According to the study, assisted living prices in Buncombe County are higher than the state ($3,693) and national ($4,000) average. Prices are lower in most other areas of North Carolina, including Charlotte ($3,803), Fayetteville ($3,100) and Hickory ($3,300); however, assisted living is more costly in Greensboro ($4,883) and Raleigh ($5,750). 

Note: Senior care cost data wasn’t available for Buncombe County, so data for Asheville, the county seat, was used. 

The wide price range for senior care in Buncombe County reflects the differences in the types of care. Adult day health services are the least costly because this type of care is provided during limited weekday hours in a communal, community-based setting. By comparison, semiprivate nursing home care is the most expensive option as it involves 24/7 medically supervised care in a licensed nursing facility. Assisted living costs slightly more than 44 hours of in-home service from a homemaker or home health aide; however, it’s important to recognize that residential senior services include room and board. 

Medicaid is the national, government-mandated health protection plan for low-income children, adults with disabilities and seniors. Federal and state governments jointly fund it, and each state administers its own Medicaid program. 

Because Medicaid is for those who would otherwise be unable to afford private health insurance or health care, income and asset limits apply for all applicants. In North Carolina, seniors who are eligible for Supplemental Security Income or State-County Special Assistance automatically qualify for NC Medicaid. 

Seniors can earn no more than $1,041 per month and own no more than $2,000 in countable assets ($3,000 per married couple). Under Medicaid rules, some assets are exempt, such as a non-revocable burial trust, personal clothing and household furnishings, one vehicle and a home worth up to $585,000 owned and occupied by the applicant or their spouse. 

If only one spouse in a married couple requires Medicaid, special income and asset rules apply. The minimum monthly maintenance needs allowance entitles the non-applicant spouse to a maximum of $3,160.50 per month, which may be paid by the applicant spouse without penalty, for use toward shelter and daily living costs. There is also a community spouse resource allowance that allows the non-applicant spouse to retain up to $126,420 in joint assets. 

Medically Needy Pathway

Seniors who meet the Medicaid asset limits but have excess income may be able to reduce their countable income and receive Medicaid services for a portion of the year under the Medically Needy pathway. Also referred to as a Medicaid spend-down program, MN allows seniors with high ongoing medical costs to use a predetermined portion of their income every six months toward medical costs. Once they have reached their MN limit, Medicaid is activated for the remainder of the six-month period.

Seniors with excess assets may be able to achieve Medicaid eligibility by purchasing non-countable items such as mobility devices, home furnishings, a prepaid funeral plan or by paying off their mortgage and consumer debts. 

Personal Care Services

Seniors who are enrolled in Medicaid, reside in an assisted living facility and have difficulty with eating, bathing, toileting, dressing or mobility may be eligible for Personal Care Services. 

This Medicaid entitlement program provides eligible seniors with up to 3.5 hours of hands-on assistance with ADLs daily. To qualify, seniors must have age-related deterioration, a chronic illness or permanent disability, and they must be assessed as needing PCS by an NC Medicaid assessor or designate. They must also: 

• Need some assistance with three of five ADLs, or
• Need a great deal of hands-on assistance with one ADL and some help with another ADL, or
• Be completely reliant on a caregiver to perform one ADL and need some help with a second ADL

Applicants who need additional assistance may qualify for up to 80 hours of PCS per month under the PCS Plus program, which requires a written recommendation from a licensed physician. 

For more information on NC Medicaid and PCS, contact Buncombe County Social Work Services at (828) 250-5500. 

Program of All-Inclusive Care for the Elderly

Seniors 55 and older who have needs that meet the Medicaid criteria for nursing home placement and would prefer to age in place in the community may be eligible for the Program of All-Inclusive Care for the Elderly. 

PACE is a managed-care program that provides seniors with the medical and nonmedical services they need to safely remain in their home or an assisted living facility. Services may include transportation, medical supplies, home care and personalized service planning.

PACE delivers all Medicaid and Medicare services from a local PACE facility equipped with an outpatient medical clinic, meeting spaces, therapy rooms and a day health area with nutrition services. 

To participate in PACE, seniors must be enrolled in either Medicaid, Medicare or both. PACE also accepts private-pay participants. 

For more information, contact CarePartners PACE at (828) 213-8442. 

State-County Special Assistance Program 

North Carolina provides Supplemental Security Income beneficiaries who reside in assisted living with additional funding to help pay for monthly room-and-board costs. 

State-County Special Assistance for adult home residents tops up the federal SSI benefit to a maximum combined monthly payment of $1,228 per month. 

Applications must be made in person or by a designated representative at the Buncombe County Health and Human Services Department, Economic Services/Public Assistance Division, 40 Coxe Avenue, Asheville. 

Veterans and survivors can contact the Veteran Service Officer at Buncombe County Veterans Services for free assistance with VA pension and benefit applications. 

VA health care services, including home-based primary care, dental, audiology and social work, are available at the Charles George VA Medical Center. 

Buncombe County Veterans Services
40 Coxe Ave., Asheville, NC 28801
(828) 250-5726

Charles George VA Medical Center
1100 Tunnel Rd., Asheville, NC 28805
(828) 298-7911

Senior Homes has an extensive directory of senior living options, with care and living providers across the United States.