Does Medicare Cover Assisted Living?

One common question asked is, does Medicare covers assisted living? The short answer is no, but there are other medical costs that Medicare does cover.

What Does Medicare Cover?

Medicare is divided into different parts, each covering specific services.
Part A covers inpatient hospital stays, skilled nursing, hospice, and some in-home health care. If you or your spouse paid Medicare taxes for a certain amount of time while working, you likely won’t have a premium associated with Part A coverage.

Part B covers doctor visits, outpatient services, medical supplies, and preventative services. While Part B requires most people to pay a premium, higher-income individuals usually pay more. Additionally, there’s a yearly deductible that you’ll have to meet, after which you’ll pay 20 percent of the Medicare-approved services that you receive.

Part D covers prescription drugs, and like Part B, you’ll pay a monthly premium, a deductible, and co-pays. If you have limited income or resources, your state may be able to help you pay for Part A and Part B. You may also qualify for a program called Extra Help that can help cover Part D.

Medicare Advantage, also known as Part C, is another way to receive Medicare benefits. These plans are offered by private insurance companies approved by Medicare. If you enroll in a Medicare Advantage plan, you will receive all of the benefits of Parts A and B, and some plans may include Part D prescription drug coverage. Medicare Advantage plans may also offer additional benefits not covered by Original Medicare, such as dental, vision, and hearing services. However, it’s important to note that Medicare Advantage plans may have different rules and restrictions, such as needing referrals to see specialists, and may not cover care outside of their network. If you’re considering a Medicare Advantage plan, be sure to carefully review the plan details and speak with a licensed insurance agent to fully understand your options.

What is Medicaid?

Medicaid is a state-administered health insurance program that provides coverage to low-income individuals. This includes seniors who need help with assisted living costs. In Arizona, the program that helps with assisted living is called the Arizona Long-Term Care System (ALTCS).

Does Medicaid Cover Assisted Living?

In Arizona, Medicaid covers a range of medical services, including doctors’ visits, prescription drugs, hospital stays, and long-term care. To be eligible for Medicaid, you must meet certain requirements, such as a review of your income and assets. If you qualify for Medicaid and intend to use it for assisted living costs, it’s important to do your research to make sure that the assisted living community accepts Medicaid insurance. Not all assisted living communities accept Medicaid insurance.

How Can Valley Senior Advisors Help?

Valley Senior Advisors can provide guidance on helping you find the best senior care for your needs. Our advisors can help you navigate the complex world of healthcare and insurance to ensure that you or your loved one finds the best care possible. If you don’t qualify for Medicaid, there are other resources that might be available to seniors and their families in Arizona.

If you need assistance finding the best senior care in the Phoenix area, contact Valley Senior Advisors today. Our services are provided at no cost to you. Call us at 480-331-8855, email us at office@valleysenioradvisors.com, or visit our website at www.valleysenioradvisors.com to learn more.

Check out our YouTube video about Medicare, Medicaid, and Assisted Living: