Does Medicare or Medicaid Pay for Assisted Living or Memory Care?

The cost of long-term care is getting higher and higher every year. The average cost of Assisted Living in the U.S is $4,300 per month (Source: Genworth). Generally, Health Insurance policies, including Medicare, do not cover the cost of Assisted Living or Memory Care. However, Medicare may pay for short-term rehab after a hospital stay, while Medicaid may pay only for people who qualify.

What will Medicare pay for?

Medicare will pay for Skilled Nursing care only if these conditions are met:

• After a qualifying hospital stay 
• When prescribed by a doctor

There will be no cost for the senior for the first 20 days. For the 21^st day to the 100^th day, the senior’s co-insurance will be $185.50 per day. After 100 days, the senior will have to pay for the entire cost, if he or she decides to remain in the skilled nursing facility. (Source: Medicare as of 4/25/21).

How do you pay for Assisted Living and Memory Care? 

The cost of Assisted Living and Memory Care is usually an out-of-pocket expense, unless the senior has a Long-term Care Insurance Policy that will cover the monthly cost of Assisted Living or Memory Care.

Long-term Care insurance will cover expenses for senior care services in an Assisted Living and Memory Care Facility or at home. Typically, the long-term care insurance company will reimburse the policy holder for Activities of Daily Living, which includes:

• Bathing
• Dressing and grooming
• Toileting
• Med Management
• Transferring
• Continence Care

Keep in mind that there are different types of Long-Term Care Insurance Policies. Be sure to check the policy details and coverage limits to know whether the Long-Term Care insurance company will pay for the partial amount or for the full monthly cost.

Medicaid, on the other hand, will help pay for the cost of long-term care, only for people with low-income and very limited assets. Some long-term care facilities, have a “Spend-down” program, which allows their senior resident to spend down their assets before converting to Medicaid. Be sure to contact your local Medicaid office to check eligibility requirements as it varies by state.

Another option to pay for long-term care is through a Reverse Mortgage on a home that your elderly loved one owns. A reverse mortgage lets you borrow money on the property’s equity. Once the senior moves out of the house, the loan will need to be repaid usually from the sale of the home. Consult a financial advisor for more details.

For war veterans and spouses of war veterans, the Veterans Administration, offers a special Pension Plan that will help pay for Assisted Living. This benefit is called the Aid and Attendance Program. For 2021, the program offers assistance up to $1,936/month for a single war veteran and up to $2,295 per month for a married war veteran. For eligibility and more details please contact your local VA office or call 1-800-698-2411.

If you need Expert Senior Care Guidance and/or FREE Assisted Living and Memory Care Community options, connect with one of our friendly Senior Care Advisors. Click here to request for FREE Care Options or call 877-523-6523.