Medicare does **not cover assisted living costs** for aging parents. Assisted living facilities provide a combination of housing, personal care services, and limited medical support for seniors who need help with daily activities like bathing, dressing, or medication management but do not require intensive medical care. Medicare, however, is designed primarily to cover medically necessary services, such as hospital stays, doctor visits, and skilled nursing care, rather than custodial or non-medical care like that provided in assisted living.
To understand why Medicare does not cover assisted living, it helps to look at what Medicare actually covers. Medicare is divided into parts:
– **Part A** covers inpatient hospital care, skilled nursing facility care (but only under strict conditions), hospice, and some home health services.
– **Part B** covers outpatient medical services, doctor visits, preventive care, and some home health services.
– **Part C** (Medicare Advantage) includes all benefits of Parts A and B and sometimes additional benefits, but it generally does not cover assisted living.
– **Part D** covers prescription drugs.
Assisted living is considered *custodial care*, which means it involves help with activities of daily living (ADLs) such as eating, bathing, dressing, and toileting. This type of care is not classified as medically necessary under Medicare rules. Therefore, Medicare does not pay for room and board, personal care assistance, or the non-medical services provided in assisted living communities.
There are some exceptions where Medicare can pay for certain medical services while a person lives in an assisted living facility, but these are limited to specific covered services. For example, if a resident receives **home health services** such as physical therapy, occupational therapy, speech therapy, or skilled nursing care, Medicare may cover those services even if the person lives in an assisted living facility. However, these services must be ordered by a doctor, provided by Medicare-approved providers, and the individual must meet eligibility criteria such as being homebound.
Medicare Part A can also cover care in a **skilled nursing facility (SNF)**, but only after a qualifying hospital stay of at least three days and only for a limited time (up to 100 days per benefit period). Skilled nursing facilities differ from assisted living in that they provide more intensive medical and rehabilitative care. Medicare does not cover long-term custodial care in nursing homes or assisted living.
Because Medicare does not cover assisted living, families often need to explore other option
