Assisted living residences are housing facilities for people with disabilities or for adults who can’t or who choose not to live independently. They provide supervision and assistance with activities of daily living.

The cost of Assisted Living Facilities nationwide can vary from $2,000 – $5,000 per month. This can obviously become costly quickly, forcing people to ask if Medicare will cover the assisted living.

Medicare, a type of health insurance for Americans 65 and older and a few other eligible people, does not typically cover the expenses associated with assisted, independent or retirement living.

Medicare typically only covers a short-term stay in a skilled nursing or rehabilitation community while an older adult is recovering from an illness or injury. It can also cover in-home rehab care performed by a home health nurse or therapist. If a doctor determines you need specialized nursing or rehabilitation after an inpatient hospital stay, Original Medicare may cover a portion of the cost. There are restrictions so be sure to talk to your doctor about your options.

It does NOT cover non-medical care services such as:

  • Assisted living
  • Long-term care in a nursing care community
  • Residential care homes
  • Non-medical home care

So what other options do you have since Medicare won’t pay?

Long-term care assistance

If you have a Long-Term Care insurance policy, it should cover assisted living.  If there is a policy designated for home care, it should be able to be used for assisted living too.

Life insurance

When you think of Life Insurance benefits, you probably only think that the funds are not available until death.  But a life insurance policy can provide financial support before that, if that’s when the money would be most helpful.

To start, talk to your Life Insurance Agent about cashing out your policy. Usually, the company is willing to buy the policy back for 50- 75 percent of its value. The rules will be different depending on the company and type of policy so be sure to investigate before you decide.

Out-of-Pocket

Personal income or savings is the simplest route, but the cost of assisted care can add up very quickly, depleting your savings. Some people opt to cash in personal investment portfolios, such as 401k plans or IRAs.  Even still, paying out of pocket is difficult to afford long-term. When all your resources have been exhausted, you can apply for Medicaid.

Medicaid

If you have no savings, financial assets, and a low income, you may qualify for government assistance.  Medicaid covers medical benefits for low income citizens with few assets.  There is no rule that requires Medicaid to pay for assisted living.  Many states will allow partial payment but not room and board.

 

While Medicare does not pay for assisted living, you do have options. If you need help finding the right Medicare plan for you and your needs, call our Medicare Benefits Hotline. We will help determine if you qualify for incredible benefits.