Medicare doesn't cover assisted living, but will continue to pay for all services approved under Parts A and B, such as hospitalizations and a doctor. Although Medicare doesn't cover assisted living, you'll continue to pay for all services approved under Parts A and B, such as hospitalizations, doctor visits, procedures and tests. Medicare won't cover most assisted living costs. Medicare doesn't pay for “custody care,” a term that refers to help with tasks of daily living, such as eating, bathing, or get dressed.
Most of the care provided in an assisted living facility is considered custody care. However, there are some assisted living costs that Medicare can cover. Contrary to popular belief, Medicare doesn't cover the costs of assisted living facilities or other long-term residential care. Under Medicare parts A and B, Medicare will pay for approved services, such as hospitalizations, short-term rehabilitation stays, doctor visits, procedures, and tests screening.
Assisted living primarily involves care in custody, such as help with daily activities, which Medicare doesn't cover. Families often wonder if Medicare pays for the costs of assisted living. The short answer is no, Medicare doesn't cover the costs of assisted living. However, there are other insurance programs and benefits, such as long-term care insurance and the veterans' assistance and assistance benefit, that can help. And some states have Medicaid programs, such as the Massachusetts Adult Group Foster Care Program.
Assisted housing residents with incomes greater than the maximum amount allowed for Medicaid beneficiaries may still be able to receive Medicaid financial aid through a variety of exemptions available in each state. Because the cost of assisted living centers is relatively high, it's important to know that they aren't your only option when it comes to long-term care. Assisted living communities offer freedom and independence to older people, and a supportive environment for older adults who may need help with their daily activities, but don't require the ongoing medical care provided by specialized nursing homes. However, Medicare doesn't cover assisted living and other types of long-term care for patients with dementia. However, when seeking financial assistance, many families wonder if federal and state programs, such as Medicare and Medicaid, can provide assisted living coverage.
Planning ahead can help you meet the costs of assisted living and make informed decisions based on your needs. There are assisted living costs, specifically room and board, that Medicaid simply doesn't cover, whether you receive Medicaid out of financial eligibility or through an exemption. If you live in a state where Medicaid doesn't cover any costs of assisted living, it may cover other types of long-term care. However, some (not all) Part C plans may cover certain non-medical services similar to those offered by assisted living centers, such as help with daily living activities, meal delivery, and transportation to and from medical appointments.
If you plan to use Medicaid to finance your stay in assisted living, keep in mind that not all assisted living communities accept Medicaid. Some military veterans and their surviving spouses who receive a VA pension may be eligible for assistance and assistance benefits that help pay for care in a nursing home, assisted living facility, or in their own home. Resources For Living is not available to members of Aetna Part D plans (by prescription only), dual eligibility special needs plans (d-SNP), special needs plans for chronic conditions (C-SNP), institutional plans for special needs (i-SNP), or Medicare supplement plans. Original Medicare doesn't cover assisted living, but it does cover short-term care in a skilled nursing facility. Fortunately, there are a variety of financial assistance opportunities that can help limit your out-of-pocket expenses.
Assisted living normally provides custody care and supervision, but not the type of medical treatment normally found in a nursing home. While some families rely on their own money, such as accumulated personal savings, pension plans and retirement accounts, to help defray the cost of assisted living, long-term care insurance can also come into play in this case.
