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Does Medicare Advantage cover assisted living?
As you age, you may encounter health challenges that are best treated in an assisted living or long-term care setting. If you’re a Medicare Advantage recipient, you may be wondering if an assisted living stay is included in your plan benefits. Typically, Medicare Advantage plans do not cover assisted living, but they may cover relevant services like short-term skilled nursing facility care and in-home healthcare services. Let’s walk through the benefits related to assisted living that are and aren’t covered by Medicare Advantage.
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What is covered and what is not?
Although care at an assisted living facility is not covered by Medicare, certain benefits can help cover related care and costs. Because Medicare Advantage plans are legally required to provide the same coverage as Original Medicare (Parts A and B), they will typically cover:
- Short-term skilled nursing facility stays: Medicare Part A, and therefore Medicare Advantage, will cover part of a stay at a skilled nursing facility for up to 100 days
- Home safety modifications: Medicare Advantage plans may cover the installation of safety modifications like wheelchair ramps, bathroom assistance bars and more.
- Personal care: Some in-home assistance may be covered by Medicare Advantage Plans, including help with grooming and bathing, medication management and mobility assistance.
- Transportation: Medicare Advantage plans may cover transportation to and from medical appointments.
- Respite care: Respite care may be included as a part of the hospice benefit of certain Medicare Advantage plans.
Eligibility for Long-Term Care Coverage
Even though long-term assisted living care is not an included benefit under Medicare, you may still be eligible for certain types of assistance. This includes a skilled nursing facility stay for up to 100 days, in-home health care (that is less than 7 days per week, less than 8 hours per day for up to 21 days) and respite care under the hospice benefit. If you have dual eligibility for both Medicare and Medicaid, you may qualify for long-term care at an assisted living facility through Medicaid.
Other Ways to Pay For Assisted Living and Associated Costs
Financial assistance for assisted living costs will vary by state. Depending on your income and eligibility, you may be able to apply for assistance through Medicaid, which offers coverage for assisted living and long-term care. You can also explore state-specific programs that offer financial support for extended care; your local Aging and Disability Resource Center may be able to offer guidance. And, if you’re a veteran, you may be able to receive long-term living assistance through Veterans Affairs programs.
Let SelectQuote Answer Your Questions about Medicare and Assisted Living Coverage
Assisted living care helps older adults with certain conditions maintain their health and quality of life. At SelectQuote, we know how important that is, which is why we’re here to guide you through your Medicare coverage options to ensure you’re getting all the benefits available to you. We’ll take the time to learn about your unique priorities and needs and work with you to find a policy that makes the most sense for your situation.
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