Many seniors who are not quite ready to enter full-time care facilities look to assisted living for a transition to keep their independence but still get the help they need for certain tasks like bathing, cooking, cleaning, and dressing.

Paying for assisted living can be a challenge for some people and it’s good to know what options you have for getting help with covering the costs. Unfortunately, Medicare does not pay for assisted living long-term, but short-term stay is covered in some cases.

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Will Medicare pay for assisted living?

Medicare pays for many different healthcare-related things for seniors once they enroll at 65. While it does cover hospital insurance, Medicare typically does not cover costs for long-term assisted living facilities like nursing homes or memory care facilities. This falls outside of typical healthcare coverage. However, while Medicare assisted living coverage is not likely for long-term stays, the program may be able to help with certain short-term stays in such facilities.  

Medicare typically does not cover costs for assisted living facilities.

Does Medicare pay for short-term assisted living? 

Some Medicare beneficiaries require short-term assisted living facilities, for example if they require some extra care and services to recover from an illness or heal an injury to get back on their feet. In this case, Medicare Part A will help to cover costs, but only if some conditions are met:

  • A skilled nursing facility (SNFs) should be Medicare-approved;
  • A stay should be prescribed by a doctor after a qualifying hospital stay (a stay in the hospital where you have been admitted as an inpatient for at least 3 days in a row). 
  • Your need for an SNF should be related to your qualifying hospital stay (e.g. a condition that initially brought you to the hospital or originated while you were staying there).
  • You must be admitted to an SNF within 30 days after leaving the hospital;

How much short-term assisted living Medicare coverage will I get? 

For Medicare beneficiaries with Part A coverage, you will get the following Medicare assisted living coverage: 

  • Day 1-20: $0 per day; 
  • Day 21-100: $204 per day in 2024; 
  • Day 101+: The patient is responsible for the full costs of skilled nursing facilities.  

As you can see, Medicare will help to cover the costs of assisted living up until a certain point. After 100 days, you will have to pay for the full costs of skilled nursing facilities. 

Medicare will help to cover the costs of the first 100 days of assisted living only.

Does Medicare cover assisted living for dementia? 

Patients with dementia may require assisted living services to help complete daily tasks like bathing, dressing, cleaning, medication management, and preparing meals. Medicare offers coverage for services for dementia patients like inpatient hospital care and physician fees.

While long-term assisted living for dementia patients is not covered by Medicare, patients can receive coverage for the first 100 days of Medicare-approved skilled nursing facility stays. Anything longer than that will become the responsibility of the patient.  

How can I pay for assisted living costs? 

Unfortunately, there are limited coverage options for assisted living covered by Medicare. Finding the option that works best for you and your income can help with the transition into assisted living care without the stress of financial burden.  

Here are a few ways to pay for assisted living: 

  • Long-Term Care Insurance: These types of policies typically have coverage options for assisted living facilities. With this type of coverage, beneficiaries can typically receive assistance for daily tasks that they may have trouble completing on their own as they age.  
  • Veteran Benefits: If you served in the military or are the spouse of a veteran and receive a VA pension, you may be qualified for certain financial assistance for assisted living facilities. If you meet the eligibility requirements for income, assets, and service, you’ll get help paying for the costs of nursing facilities, assisted living, and at-home care.  
  • Medicaid: In some states, Medicaid coverage can help you meet the financial requirements for assisted living facilities. Assisted living coverage does vary by state and you must meet the eligibility requirements for income and assets. While this process does involve a long waiting list, it is a good option for those with low income looking to find ways to pay for assisted living facilities.  

How much do assisted living facilities cost? 

Assisted living facilities generally cost about $4,500 per month or $54,000 annually on average for the United States. Many people rely on pensions and personal savings to cover the costs of assisted living. This price will vary based on locations, the size of the facility, and the services needed while living in the facility. Some facilities offer a la carte options for residents. If you need minimal care, your costs will likely be lower. 

Conclusion 

Medicare coverage does not typically cover the costs of assisted living facilities. Those beneficiaries with Part A coverage will receive help covering the costs of assisted living facilities for the first 100 days. After this, the cost becomes the responsibility of the patient, and the facility must be a doctor-prescribed Medicare-approved skilled nursing facility to be eligible for coverage. There are other options for paying for assisted living facilities as you age like veteran benefits, long-term care insurance, and Medicaid in some states. 

Article updated on December 18, 2023