While Medicare doesn't cover assisted living, you'll still pay for all services approved under Parts A and B, such as hospitalizations. 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. 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. The cost of long-term care depends on the level of care you need, where you live, and the type of assisted living facility you choose. Assisted living communities allow residents to enjoy independence and privacy, but they also have staff who help them with daily care. Assisted living is an option for people who can usually take care of themselves, but who need help managing tasks such as household chores, meals, or other tasks.
Medicare covers certain costs for people with dementia, such as hospital care, cognitive evaluations, home health care, palliative care, medications (depending on Part D), and care in specialized nursing homes. However, some states have exemption programs that provide certain Medicaid coverage for assisted living to eligible applicants. Planning ahead and understanding available resources can contribute to a smoother transition to assisted living and ensure financial well-being during the long-term care process. 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. If you live in a nursing home and have full Medicaid coverage, you won't pay anything for covered drugs after Medicaid has paid for your stay for at least one full calendar month.
Because assisted living isn't considered a medical need, it's not included in original Medicare coverage. Because it's designed to supplement coverage, Medigap doesn't pay for assisted living or other types of long-term care. Resources For Living is not available to members of Aetna Part D plans (by prescription only), dual eligibility plans for special needs (D-SNP), special needs plans for chronic diseases (C-SNP), institutional plans for special needs (i-SNP), or add-on plans of Medicare. Several states offer help to cover the costs of assisted living for eligible older adults who have limited financial resources (e.g., some services provided in an assisted living home may also be included in their Part A coverage.
