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. Medicare is most often used to pay for skilled nursing facilities or home health care. Use this resource to find out if it's a test, an item, a service, and so on. Most families cover the costs of assisted living through private funds, which are usually a combination of Social Security benefits, pension payments, and savings and retirement accounts.
There are also some financial tools, retirement benefits for veterans, and government programs that can help cover the costs of assisted living. For eligible seniors, Medicaid and SSI funds can be used to cover some assisted living expenses. Each state designs its own Medicaid program, so application processes, eligibility criteria, and coverage vary. The simple answer is “yes,” in most states, Medicaid will pay for long-term assisted living services and supports, including memory care (care units for people with Alzheimer's).
People who meet the financial and functional eligibility requirements may be available to long-term services and supports, such as personal care assistance, homemaker services, emergency response systems and skilled nursing. While Medicaid will never pay for room and board, most states try to make this cost affordable for Medicaid recipients. Most people pay for assisted housing with their current Social Security income and pensions, along with the use of their savings, including income from the sale of a home. Long-term care insurance is increasingly being used to offset the cost of assisted living. Some consumers convert life insurance policies into loans, and others have family members who help pay a portion of the monthly cost.
For most families, private payment is the primary method for covering the costs of assisted living. While this may seem overwhelming, there are several strategies to make it more manageable. Knowing how to structure payments and explore creative solutions can often save families thousands of dollars. For older people who own property, real estate can be a powerful resource for financing the costs of assisted living.
Assisted living centers are a type of residential center where older adults and people with disabilities can live when they can't live safely or comfortably in their own home. Seniors and people with disabilities enrolled in an HCBS Medicaid exemption can live in a variety of environments and receive Medicaid-funded benefits. Although rare, the Department of Public Health allows some Connecticut assisted living services agencies to provide skilled nursing services, such as insulin injections. For personal care assistance through the regular state Medicaid plan, the same level of care in a nursing home is not required.
Because it's not considered medically necessary, original Medicare (parts A and B) doesn't cover the costs of assisted living. All states offer personal care assistance funded by Medicaid, but some states offer it only through regular Medicaid, others offer it only through HCBS Medicaid exemptions (which may include a waiting list), and yet in other states, it is offered through regular Medicaid exemptions and HCBS. Professional Medicaid planners can help implement strategies to meet financial eligibility requirements without jeopardizing Medicaid eligibility. It's important to note that some communities provide residents with all of the daily services described in their personalized care package without having to closely follow up on scheduled or unscheduled services or assistance.
People age 65 and older or who have physical disabilities are the most likely to qualify for home care coverage in Medicaid assisted living facilities. Even in assisted living communities that offer all-inclusive care prices, help with medication management and incontinence is often not included. The cost of assisted living can vary widely but is essentially based on the type and characteristics of the apartment and the amount of services needed by a specific resident. If your parents decide they want to move to assisted living, or if they need to move there to maintain their quality of life, figuring out how to afford it can be a challenge.
The KFF asked states what services they provide in assisted living centers through Medicaid home care programs using the Centers for Medicare and Medicaid Services (CMS) list of services, which are classified under a comprehensive taxonomy. There will be help for personal care needs, such as bathing, dressing and grooming, as well as assistance with medications, but it may or may not be included in the basic rate. While these benefits may not be enough to pay the full bill, they can make assisted living more affordable.
