Original Medicare (Part A and Part B) 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.
Some Medicare Advantage (Medicare Part C) plans may offer some assistive care, such as home health aides and caregiver support.
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:
- Hospital stays
- Inpatient stays at skilled nursing facilities
- Certain inpatient hospice care services
- Hospice home care
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:
- Dental
- Vision
- Hearing
- Prescription drugs
- Health and wellness programs such as SilverSneakers
These additional benefits can be utilized whether you are residing in an assisted living facility or not.
Enroll in a Medicare Advantage plan that covers your living needs
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 Medicare Advantage plans that help cover assisted living care
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