FAQs on Medicare/Medicaid and Assisted Living Facilities

November 15, 2020 0 Comment Category: Assisted Living

Healthcare costs are often the prime concern for families looking for senior living options. On average, assisted living facilities can cost anywhere from $2,000 to $4,000 per month or even more depending upon the location, the services included, and the amenities offered by the assisted living community. Therefore, it is important to be aware of your options and know how you can finance the senior care services for your elderly parent or grandparent.

Below are some of the frequently asked questions about Medicare and Medicaid in regards to their coverage offered for senior care and assisted living.

Does Medicare Pay for Assisted Living Costs?

Medicare Part A, Part B, and Part C do not provide any cover for assisted living or retirement home costs. Instead, they only pay for the expenses associated with medical care for seniors, which may include a short-term stay in a skilled nursing home or a rehabilitation facility. Medicare can also be used to cover the costs of in-home care if the senior is recovering from an illness or injury and needs specialized healthcare supervision from a home health nurse or therapist. However, Medicare does not pay for any kind of long-term care, be it in an assisted living community or a nursing care center.

Does Medicaid Pay for Assisted Living Facilities?

Medicaid is a type of health insurance that is designed to serve low-income families and individuals with only a few assets. So seniors can qualify for Medicaid coverage only if they meet certain criteria set by the federal and state regulatory bodies. However, Medicaid programs cover only certain aspects of senior care costs for eligible residents and not the expenses of living in an assisted living community. In general, seniors can use Medicaid to pay for senior living services like specialized nursing care, case management, medical assessments, as well as medication management.

Does Medicare/Medicaid Pay for Memory Care?

Medicare provides coverage for medically-necessary care to seniors who are diagnosed with dementia or any other type of memory impairment. However, it does not pay for personal care, custodial care, or the expenses of memory care communities. Instead, Medicare can be used for inpatient hospital stays, hospice care, and skilled nursing care for up to 100 days. Medicaid, on the other hand, can be used to pay for the services provided by memory care facilities if it is a Medicaid-contracted facility. Otherwise, Medicaid will consider non-contracted memory care communities as assisted living facilities and will not cover any long-term stay.

What Does Medicare Cover for Senior Care?

Medicare benefits can be used to cover many kinds of expenses related to the healthcare needs of seniors, such as emergency ambulance services, emergency care, lab and diagnostic tests, kidney dialysis, diabetes care, transplants, and more. In some cases, Medicare Health Plans may also provide cover for additional services, such as doctor appointments, dental care, vision check-ups, prescription drugs, treatment for macular degeneration, and preventive care services. Eligible seniors can also pay for physical therapy and medical equipment using Medicare.

How Do I Pay for Assisted Living Care?

Long-term care at an assisted living community can incur many different types of costs depending upon what services you need and the level of care required for your loved one. Generally, seniors with long-term care insurance policies can use that to pay for their assisted living costs. However, the coverage by the insurance will vary as per the terms mentioned in the policy. Apart from that, you can also pay for the costs of assisted living communities through personal finances, such as by selling assets of your elderly parent or grandparent. You can also seek bridge loans to cover the costs until you find a robust solution to pay for assisted living.

Contact The Falls Home to discuss your assisted living payment options