Does Medicare Pay for Assisted Living?

Medicare generally does not pay for the long-term room, board, or personal care most people receive in assisted living.

That's because Medicare treats most long-term assistance with everyday activities — bathing, dressing, eating, or using the bathroom — as custodial care. Medicare does not generally cover custodial long-term care when that's the primary type of help someone needs.

So does Medicare pay for anything while someone lives in assisted living?

It can. A resident may still use Medicare for covered medical services, just as they would if they lived at home. Depending on eligibility and the service involved, that might include things such as:

• Doctor visits
• Hospital care
• Certain therapies
• Medical equipment
• Prescription coverage
• Qualifying home health services

The important distinction: Medicare may pay for medical care you receive while living in assisted living. It generally does not pay the assisted living bill itself.

What about skilled nursing?

That's different. Medicare may cover short-term skilled nursing facility care when specific requirements are met. That's not the same thing as paying indefinitely for assisted living or long-term custodial care.

What might help pay for assisted living instead?

Depending on the person's circumstances, families may want to investigate:

• Arizona Medicaid long-term-care programs such as ALTCS
• Long-term-care insurance
• Veterans benefits
• Personal income and savings
• Proceeds from a home sale or other assets
• Certain life-insurance arrangements

Each has its own eligibility rules and limitations.