The Arbor Company Senior Living Blog

Understanding Medicare: Is Assisted Living Covered?

Dec 19, 2015 1:00:00 PM / Rebecca Smith Rebecca Smith


When you begin to look at senior living options, it is wise to consider how the expenses will be covered. For many seniors, the process of examining the housing benefits available to you will begin with knowing all about Medicare. Most seniors opt to purchase basic Medicare coverage, at a minimum. However, Medicare might not be a payor source for specific types of senior living.

What is Assisted Living?

Assisted living communities differ from skilled nursing facilities, sometimes known as nursing homes. When it comes to assisted living, these communities operate under a different license and have different state and federal regulations. While skilled nursing facilities are required to have 24 hour nursing and clinical staff onsite, assisted living communities are not.

Most assisted living communities cater to residents who require some assistance with activities of daily living. These activities may include dressing, showering, medication reminders or distribution, and toileting. Assisted living communities usually feature a dining room or restaurant with three meals per day that are prepared by a knowledgeable chef. Meals prepared are not only delicious, but are individualized to meet medically prescribed diets.

Assisted living also typically offers an event calendar for residents to enjoy. Activities can range from exercise classes like yoga to entertainer performances to trips or classes. These activities are crucial to healthy socialization and can complement therapy services. A good assisted living community will thoughtfully tailor engagement activities to the needs, abilities, and interests of its residents.

Medicare does not cover assisted living community costs. There are some assisted living communities that accept Medicaid as payment, but Medicare does not pay for assisted living expenses. That said, Medicare does cover some services that might be available within the walls of the assisted living community, such as therapy services or preventative care appointments. This coverage can help offset the overall price of assisted living.

What About Memory Care Assisted Living?

Memory care communities that operate under a specialized assisted living license are subject to their own regulations. In these cases, the staff to resident ratio is typically smaller so as to provide more assistance and guidance to residents who may become disoriented or confused. Meals are offered during the day, typically in a special dining room, and diet intake is carefully monitored by staff members to assure residents are getting enough calories to thrive. Some memory care communities, such as those that are part of The Arbor Company, offer food that is specially prepared and designed to make eating easier for those with difficulty tasting, swallowing, or manipulating flatware. Activities are offered within a memory care community as well, often more than a typical assisted living community.

Even though memory care assisted living communities typically are working with residents who have a higher need of care, cueing, and assistance, Medicare still does not pay for these services. Services such as doctor prescribed physical or occupational therapy services may be covered under Medicare, but other expenses are not.

How Can I Pay For These Services?

While Medicare does not pay for assisted living services, you have other resources to explore when considering assisted living care. Beyond using assets such as your home or car, you may also have a long-term insurance plan that covers some of the costs associated with assisted living care services. Finally, you can investigate whether you qualify for Medicaid, which may help pay for certain assisted living communities, although not all.

As always, the first step to senior living is research. The more you know before you make a decision - or before a crisis occurs - the better prepared you and your finances can be.

Interested in learning more about independent and assisted senior living in your area? Contact us now to request more information about our premium senior living communities. 

New Call-to-action

Topics: Understanding Medicare

Rebecca Smith

Rebecca Smith

Rebecca is the Regional Vice President of Sales at The Arbor Company.

Subscribe to Email Updates

Lists by Topic

Posts by Topic