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. 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. While Medicare is invaluable for medical expenses, it doesn't cover long-term assisted living costs, such as rent, meals and most personal care services. While there are ways to help offset the cost of assisted living, many people are surprised to learn that it usually pays out of pocket. There are several ways to finance the costs of assisted living, from personal savings to Medicaid exemption programs. In most states, Medicaid helps pay for some assisted living services, with different eligibility requirements.
Assisted living normally provides care and supervision in custody, but not the type of medical treatment normally found in a nursing home. Some services provided in an assisted living home may also be included in your Part A coverage. While Medicare offers limited coverage for assisted living medical services, it doesn't pay for housing or personal care. If you've determined that assisted living is the best option for your loved one, the next step is finding the right community. Because assisted living isn't considered a medical need, it's not included in Original Medicare coverage. Some older long-term care policies may offer lower benefits for assisted living than for nursing homes. Medicare generally offers limited support, while Medicaid may provide more assistance, depending on eligibility and specific state programs.
While some families rely on their own money, such as accumulated personal savings, pension plans and retirement accounts, to defray the cost of assisted living, long-term care insurance can also be useful in this case. Assisted living communities are all unique, with different features and services that range from dining rooms and common social areas to libraries and movie theaters. While assisted living offers comfort, security, and peace of mind, many families are surprised to learn that, to a large extent, they are paid out of pocket, since Medicare offers limited support and Medicaid assistance varies greatly by state and requirements. No, Medicare does not pay for a short-term stay in assisted living, since assistance with personal care tasks is not considered medically necessary. 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.
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.
