Medicare does not cover the costs associated with residing in an assisted living community. Medicare only pays for long-term care if you require skilled nursing or rehabilitative services, and even then, Medicare only covers it for a certain duration. It does not cover non-skilled assistance with daily activities, which comprises the bulk of assisted living care. With that said, even if you move into an assisted living community, Medicare will continue to cover your prescription medications and/or other medical services that would have otherwise been covered by your particular plan if you still lived at home.
Medicare Part A, which is hospital insurance, does not pay for assisted living. It covers:
- Inpatient care in a hospital
- Skilled nursing facility care
- Skilled nursing home care
- Hospice care
- Home health care
Medicare Part B, which is medical insurance, covers:
- Outpatient care
- Medically necessary care (services or supplies needed to diagnose or treat your condition)
- Preventative care, such as the flu shot and laboratory tests
Does Medicare Advantage Cover Assisted Living Costs?
Medicare Advantage plans, which are commonly referred to as Medicare Part C, does not cover the costs associated with assisted living, either. However, there are thousands of Medicare Advantage plans available nationwide that are sold by private insurance companies, and each plan offers its own unique benefits with various costs.
Does Medicare Supplement Cover Assisted Living Costs?
Medicare Supplement plans, also known as Medigap plans, are designed to cover the gaps left by Original Medicare coverage. Medigap plans are required by the Centers for Medicare & Medicaid Services (CMS) to provide standardized benefits nationwide, but premiums can vary from provider to provider. Similar to Medicare Advantage plans, Medigap plans don’t cover the costs associated with assisted living.
How Much Does Assisted Living Cost?
Assisted living costs an average of $119 a day, or $3,628 a month, according to the government’s Administration on Community Living. Many assisted living facilities can cost $5,000 per month or more. Innovation Senior Living communities offer affordable assisted living options. People pay for assisted living out of pocket, with Medicaid (a federal and state program that provides free or low-cost health care to people with limited income or resources) or with private long-term care insurance. Some also finance it with reverse mortgages, life insurance options and annuities.
How to Pay for Assisted Living
If you do not have significant savings to draw from to pay for assisted living, other options may be available to you.
Aid & Attendance is a need-based benefit offered to eligible veterans by the U.S. Department of Veterans Affairs (VA). Received in addition to a VA pension, this monthly stipend may be used to cover the cost of a long-term care or assisted living facility.
To be eligible for this benefit, a veteran must meet at least one of the following criteria:
- They are confined to a bed.
- They are a resident of a long-term care facility.
- They need assistance with activities of daily living (ADLs).
- They have severe vision impairment.
Medicaid Assisted Living Coverage
Medicaid covers some costs of assisted living for residents who qualify. Recipients must:
- Live in the state in which they’re applying for Medicaid.
- Reside in an assisted living facility that’s licensed for Medicaid.
- Meet certain financial need requirements.
- Demonstrate a functional need for assisted living.
Benefits and requirements vary from state to state.