Medicare Part A only covers skilled nursing care and only for up to 100 days. Your eligibility for Medicaid depends on your income. 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 exams. States are banned by the federal government from using Medicaid funds to pay for the cost of room and board for residents of an assisted living community.
If you're lucky, you might live in a state that places a legal limit on the amount that assisted living communities can charge for services that government programs don't cover. You may want to have a long time to find new housing, since Medicaid certified assisted living centers are few and far between because reimbursement rates are very low. If you or someone you know is considering nursing home care, make sure you fully understand what services are covered and what Medicare doesn't pay for. It should be noted that Medicare only pays for a maximum of 100 days of care in a skilled nursing facility during each benefit period. Be sure to visit the NCOA BenefitsCheckUp to look for other benefit programs that can help you pay for health care, food, prescription drugs, utilities and other basic living costs.
Assisted living expenses may also vary depending on the services provided and the specific services needed by the resident. Because the cost of assisted living centers is relatively high, it's important to know that they aren't the only option when it comes to long-term care. In most cases, Medicare won't pay for the cost of long-term care, including nursing homes and assisted living. Despite states' freedom, the federal government does not allow states to pay any assisted living charges related to room and board. Some older long-term care policies may offer lower benefits for assisted living than for nursing homes.
The cost of assisted living depends on where you live, the type of facility and the level of care you need. However, some states have exemption programs that provide certain Medicaid coverage for assisted living to eligible applicants. There are assisted living costs, specifically room and board, that Medicaid simply doesn't cover, whether you receive Medicaid out of financial eligibility or an exemption. In states that offer part of Medicaid assistance to assisted living residents, custody and cleaning services are some of the many services they usually cover.
While coverage for long-term care in nursing homes is limited, Medicare provides other important benefits to nursing home residents.
