Does Medicare Cover Senior Living? - Stellar Living

Does Medicare Cover Senior Living?

Senior living is a great choice for many people. It may even be medically necessary. Medicare is a government-provided financial assistance program for hospital and medical expenses. It covers everyone over the age of 65, or those who are disabled. So, does Medicare cover the rent and expenses of Senior Living Communities?

The short answer is: it depends on your state, your income and age, how much care you need, the length of the stay, and the type of Senior Living Community…but for most people, Medicare will probably not cover your expenses at an independent Senior Living Community. It may cover a skilled nursing or assisted living facility in some cases. But even if Medicare won’t cover your Senior Living arrangements, Medicaid and other programs might. Basically, it’s very confusing. Here’s a super-simplified breakdown of the different programs available and what they will cover.

Medicare.

Medicare can help provide long-term care, like an assisted living facility, for people with medical conditions that may not improve and require care to prevent decline. These conditions include things like Alzheimer’s, stroke, Parkinson’s Disease, ALS, and Multiple Sclerosis. 

If you do not have one of the covered medical conditions, skilled nursing facilities are usually the only long-term care Medicare will typically cover. Medicare will pay for a short-term stay (up to 100 days) in a skilled nursing facility following hospitalization, if you meet the necessary qualifications. If you meet them,  Medicare will pay for 100% of your stay in a skilled nursing facility for up to 20 days. For stays between 20 and 100 days, it will cover some of the costs, but you will have to pay a daily co-pay. Medicare will not cover any more than 100 days in a skilled nursing facility, unless your doctor determines it is medically necessary for you to receive part-time or intermittent skilled nursing care. 

Medicare usually does not cover assisted living care or personal care services (such as dressing, bathing, and other daily activities) for most people. However, you may be eligible for other programs that help cover the cost of Senior Living Communities, like those listed below.

Medicaid.

Medicaid is a federal and state financial aid program intended to help low-income people with medical expenses. Medicaid does cover some long-term care services, including the type of care you may receive at a Senior Living community. However, what Medicaid covers largely depends on what state the Senior Living Community is in. Here’s more information on Medicaid and Medicaid eligibility. You can see the Medicaid requirements and coverage for each state here

Veteran’s Affairs Benefits.

If you are a veteran, the VA provides some financial assistance with care needs. It will cover some long-term care, like an assisted living facility, if it is medically necessary and you are unable to cover the cost. Find more information on the VA website

State-Specific Programs.

Many states offer programs to help with long-term care, which may include Senior Living Communities. Find programs in your area here.

So the bottom line is: Medicare doesn’t usually cover most Senior Living Communities. But even if Medicare won’t cover it, there are many other programs available and many ways to finance Senior Living. Stellar Living’s Family Advisors are well-versed in Medicare requirements and the programs in their state. Give us a call anytime to find out more.

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