Does Medicare Cover Assisted Living?
Short answer
Original Medicare generally does not pay assisted-living room and board or long-term custodial residence, but residents can still receive separately covered Medicare medical services.
Coverage
Covered services can include physician care, hospital services, qualifying therapy, DME and other Medicare-covered treatment when the individual service meets Medicare rules.
Not Automatic
Meals, housing, personal care and supervision are generally custodial services and are not converted into Medicare-covered benefits merely because they are delivered in assisted living.
Costs And Ma
Medicaid or state programs may help some eligible residents. Medicare Advantage supplemental benefits, if any, are plan-specific and cannot be assumed.
Practical Example
A resident may have a covered Part B physician visit while still paying privately or through another program for the assisted-living residence itself.
Questions to verify
- Which charges are for medical services versus room and board?
- Could Medicaid or another program help?
- Does my current plan offer any supplemental support?