Assisted living is a common need that Medicare won't pay for. Here's what's excluded and how families cover it.
Why Medicare doesn't cover assisted living
Assisted living provides housing, meals, and help with daily activities like bathing, dressing, and medication reminders. This is considered custodial, non-medical care, and Medicare does not cover custodial care or the room-and-board cost of an assisted living facility. This applies whether you live in assisted living short-term or permanently. Many families are surprised by this, since assisted living can cost thousands of dollars per month. Medicare's role is limited to the medical services you receive, not the residence itself. Planning ahead for these costs is essential. To understand your options for covering assisted living, call 1-800-MEDIGAP at 1-800-633-4427 for free guidance.
What Medicare does cover, and how to pay for assisted living
While living in assisted living, you keep your full Medicare benefits for medical care: doctor visits, hospital stays, covered preventive services, medically necessary therapy, and prescription drugs through Part D. Medicare just won't pay the facility's room, board, or personal care charges. Families typically pay for assisted living through personal savings and income, long-term care insurance, veterans benefits, or Medicaid, some states offer Medicaid waiver programs that help with assisted living services for those who qualify financially. A licensed agent can help you understand how Medicare coordinates with these. Call 1-800-MEDIGAP at 1-800-633-4427 to plan ahead.