Many elders need the safety and supervision that an assisted living facility can provide. Does Medicare cover the financial burden of a facility that provides a place for the elderly to live out their years? Being able to answer this question can mean the difference between seriously considering assisted living for a loved one or choosing a different option.
In order to answer this question about whether Medicare will help pay for any type of assisted living, its important know what Medicare is.
What is Medicare?
Medicare is a health insurance program, administered by the U.S. federal government established in 1966, for the elderly who are 65 years of age or older. Medicare pays for some of an elder’s health care costs but it doesn’t cover the entire expense. Coverage applies to most acute medical conditions in which a patient recovers.
Care given in the home, at a nursing home, or in an assisted living facility is not covered by Medicare. Medicare provides benefits in four parts – A, B, C, and D. Part A provides the benefits that help pay for inpatient hospital care, some skilled nursing facilities, hospice care, and some home health care.
Medicare only covers the cost for assisted living when a person is considered homebound. In this instance, the person is unable to travel to a medical facility for treatment. If a person needs a licensed professional to provide services, such as physical or speech therapy, wound care, administering injections, then Medicare will cover assisted living costs. Services such as bathing and dressing a person do not qualify for coverage under Medicare.
Medicare does not cover long-term care but someone recovering from an injury, surgery, or illness that requires the assistance of a licensed professional is like to meet the Medicare requirements for coverage. Non-medical nursing home or assisted living facility care “custodial” is not covered.
For those individuals who require any type of long-term care, they may be able to find some level of support through Medicare for assisted living, but the care that they would need must come from the recommendation or directive of a medical professional, their doctor.
There are other options with regard to assisted living and while some people might think that assisted living is as costly as nursing home care, it’s not. A personal care home is actually quite a bit cheaper than any type of nursing home you would find.