Does Medicare Cover Assisted Living?

“How much?” That’s one of the biggest questions people ask as they tour our assisted living homes. It is right after excellent care. Once people know the prices, they start wondering how they will pay for our services. They also want to know what programs can help. We receive a lot of questions like “Does Medicare cover assisted living?” or “Does Medicare cover assisted living for Dementia?” or “Does Medicare cover assisted living facilities?” or “What does Medicare cover for assisted living?”. As you can see, there are a lot of questions.

The short answer is ‘No’. Nearly all the residents in our assisted living homes pay from various private sources:

• Savings
• Selling a home
• Family and friends
• Pensions
• Social security
• Other income

Although it doesn’t cover assisted living, the question what does medicare cover for assisted living may be more appropriate. Medicare does cover some services offered to residents in assisted living. Some examples include:

• Physical therapy
• Skilled nursing care
• Personal care
• Respite care
• Transportation to and from medical appointments
• Case management
• Hospice

People also thinks medicare will cover certain long-term medical conditions. Although they might cover the actual treatment of the issue, the answer to a question such as ‘Does Medicare cover assisted living for Dementia?’ is still a ‘No’.

Does Medicare Cover Assisted Living? Or Medicaid?

In many cases Medicaid can help where Medicare cannot. Each state has their own Medicaid requirements. In Arizona the most popular program for assisted living is the ALTCS(Arizona Long Term Care Service) program. ALTCS can cover assisted living. ALTCS will require families to pay a certain amount of the resident’s monthly income from Social Security or other programs, and ALTCS will pick up the rest. Typically we’ve seen families have to pay between $200 and $1,500 depending on their monthly income. ALTCS will still leave the resident with some money to spend on incidentals.

There are some requirements for qualifying for Medicaid, and for the ALTCS program. We wrote a guidebook about ALTCS that you can find here. The guidebook may not have the most up to date information. You may want to contact a service such as an elder law attorney or financial consultant to determine the best way to qualify.

Does Medicare cover assisted living facilities? No but the VA Might

There is another government program that will cover assisted living – if you’re a veteran. It’s called Aid and Attendance. The program is available to anyone who was in the military for at least 90 days during a time the United States was fighting a war. You didn’t have to be in the war. The fact you were in the military at that time qualifies you. Oh and you also need an honorable discharge. Aid and Attendance won’t pay all of your assisted living, but it will help you and your spouse defray several thousand dollars in costs each month.

Long-term care insurance policies are also a great way to pay for assisted living. If you’re looking for an assisted living home right now, this may not be a great solution. You have to sign up for Long-Term Care insurance well before you need it. If you did sign up for it, you may find it will cover assisted living costs up to 100%. If you have long term care insurance, you won’t have to ask the question “Does Medicare cover assisted living facilities?”

So although you may not be able to use your Medicare benefits to pay for assisted living, you may be able to find another way. You can also use your Medicare benefits with other programs to cover assisted living and most other aspects of your long-term care needs. We have a lot of connections in the health care industry. Especially around Goodyear, Surprise and Sun City AZ. If you need to find some answers, please contact us!