As you age, living on your own can become more difficult — and the same is true for aging family members who might need extra care. You or your loved ones may not need care at all times, but living in a place where you know there are a few extra sets of hands around to help can give you some peace of mind.
Many people choose to move into assisted living facilities for that reason. But does Medicare cover assisted living? You might be surprised to find that the answer is no. If you're exploring the option of assisted living or planning for it currently — whether for yourself or for a family member — you should consider how to cover these costs before you make a decision.
What Is Assisted Living?
As people age, they often need more help with day-to-day activities. Assisted living facilities occupy the middle ground between living independently on your own, or aging in place, and living in a full-time nursing facility. Assisted living facilities offer extended care for individuals who need medical assistance from time to time, but not active care all the time. In addition to the professional staff who work at assisted living facilities, there are also medical professionals on standby to take care of scheduled medical needs or emergencies.
Assisted living is an attractive option for many people because it can offer a considerable degree of independence. For instance, an assisted living community might offer private apartments and units with staff nearby to help with day-to-day activities. Many facilities provide daily meals and transportation options for outings and community social events as well.
Does Medicare Cover Assisted Living?
Medicare Part A, which accounts for hospital insurance, can cover a portion of the costs of rehabilitative long-term care in a skilled nursing facility, usually for up to 100 days. That means if you or a loved one are ill or in need of daily care, physical therapy or wound care for a few months, Medicare Part A can help.
However, if you or your family member don't require that amount of skilled daily care and will instead need care in the form of assisted living, Medicare will not cover the costs. Medicare doesn't cover custodial care, which is non-medical care that can include bathing, dressing, making meals and general supervision — offerings that assisted living facilities provide.
Medicare Part B, which is a more general form of medical insurance, can help cover doctor's appointments, preventative screenings and tests. However, it will not cover the costs of assisted living.
Part C plans (also known as Medicare Advantage plans) typically don't cover assisted living either. However, depending on the type of plan you have with your private insurer, a Part C plan could cover some of the services your assisted living facility does not provide, such as wellness programs or transportation to medical appointments.
Medicare Part D, which accounts for prescription drug costs, will cover you regardless of whether or not you are staying in an assisted living facility.
How Long-Term Care Insurance Can Help
Staying in an assisted living facility is often expensive. Because Medicare does not cover the costs of doing so, it's important to consider how you will pay for assisted living, especially if you think you or a family member will need it in the future.
One option is long-term care insurance, which can help cover the costs associated with assisted living facilities. Long-term care insurance can also help pay for nursing home services and home health care in the event that you have an illness or a disability that leaves you unable to care for yourself. In addition, long-term care insurance can help fill gaps in coverage between what is provided by Medicare and what is provided by Medicaid, a government-sponsored health care program for low-income Americans.
If you are planning for your future care and considering assisted living, or are looking into this living situation on behalf of a loved one, be sure to explore all of your options. By doing some research and ensuring that you understand what coverage Medicare provides, you can make informed decisions that will lead you and your family to a more stable and satisfactory retirement.