Does Medicare Cover Assisted Living?

Original Medicare does not typically cover the cost of assisted living, but it may cover some of the health care needs that are often required by assisted living residents.

Certain Medicare Advantage plans may offer some of the assistive care that beneficiaries are looking for, but typically don’t cover long-term care.

Woman smiles while standing in garden

Original Medicare does not cover custodial care

Much of the care that is administered in an assisted living facility — bathing, dressing, eating, etc. — is categorized as “custodial care,” which is not covered by Medicare.

Qualified inpatient care that is covered under Medicare Part A can include:

Long-term stays in assisted living facilities or retirement homes are not included in Medicare Part A coverage.

Medicare may cover some services provided in an assisted living facility

Although the housing cost charged by an assisted living facility will not be covered by Medicare, residents of assisted living homes can still benefit from Medicare coverage for certain services.

Assisted living facilities typically have nurses on staff or nurses who visit throughout the day to treat injuries, illness and help manage medications. Any such medical (non-custodial) care received in an assisted living facility by a health care provider may be covered by Medicare in the same fashion that it would be covered at other facilities.

Some Medicare Advantage plans may help assistive services

Starting in 2019 and going forward, Medicare Advantage plans can begin covering a range of new services and benefits geared toward independent care.

Some of the benefits that can be covered can include:

  • Transportation to doctor’s appointments
  • Home-delivered health meals
  • Bathroom grab bars
  • Home health aide services to help with certain tasks
  • Assistive devices such as pill cutters and personal electronic activity trackers

The federal government is allowing private Medicare Advantage plans to offer these additional benefits as part of a push to further support aging in place and independent care.

Some Medicare Advantage plans may also offer additional benefits such as:

These additional benefits can be utilized whether you are residing in an assisted living facility or not.

Enrolling in a Medicare Advantage plan

If you are considering an assisted living facility for yourself or a relative but are concerned about the cost, contact a licensed insurance agent today to learn more about Medicare Advantage plans available in your area that may help cover some of the costs of assisted living and independent care.

Find the answers you need and have a licensed insurance agent walk you through the enrollment process. Get started today by calling TTY Users: 711 24 hours a day, 7 days a week.

 

Learn more about what Medicare covers

Copyright © 2018 TZ Insurance Solutions LLC. All rights reserved.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.