Regrettably, Medicare typically does not encompass the expenses associated with assisted living or long-term care facilities. Conventionally, Medicare is designed to cover costs related to skilled nursing facilities or home health care. However, there is an exception to this rule, as Medicare can extend its coverage to include medical expenses incurred at an assisted living facility.
In most cases, residents cover the costs of assisted living through personal funds or rely on long-term care (LTC) insurance to partially cover these expenses. Often, private funds and personal assets, which may stem from the sale of a home or retirement savings, are the primary sources used to finance assisted living facilities.
For instance, if a medical professional determines that specialized care is necessary after a hospital stay, Medicare may contribute to the cost of a brief stay at an assisted living facility. In cases where individuals have limited income, Medicaid may step in to assist seniors and people with disabilities in affording assisted living. Yet, in many instances, individuals must first deplete their personal assets to meet the eligibility criteria for Medicaid coverage. Since Medicare and Medicaid regulations concerning assisted living can be complex, it's advisable to consult with two or more experts to ensure you maximize your benefits and minimize out-of-pocket expenses.
Assisted living serves individuals who can still independently perform many daily activities but require some level of support from staff, as opposed to the constant medical attention necessary in nursing homes or more advanced senior care alternatives. Generally, to qualify for long-term care insurance benefits, an individual must require assistance in at least two major activities of daily living.
For comprehensive information on your options for covering the expenses of assisted living, please reach out to us. Our knowledgeable representatives will assess your situation and discuss available resources to help you afford the services offered by assisted living.
