Assisted Living: Types, Costs, and Medicare Coverage
What Is Assisted Living?
Assisted living facilities can provide a level of independence for people who need help with activities but don’t require the medical or care services provided by more advanced care facilities. Medicare does not cover assisted living costs, however, long-term care insurance will.
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What Is Assisted Living for Seniors?
Assisted living is a form of eldercare that aids older people who need help with daily care but still don’t need as much help as a nursing home would provide.
The care that is provided in assisted living facilities may serve as few as 25 people or more than 120. Assisted living facilities typically provide different levels of care. The higher the level, the higher the price for care.
Residents in assisted living facilities have their own rooms or apartments within the facility. Facilities also have common areas where you can socialize with other residents, offering normalcy through retirement life.
Assisted living facilities are one of several senior living arrangements that help care for people as they age.
What Does Assisted Living Provide?
Assisted living facilities provide services for people who need help with activities of daily living and who may no longer be able to live independently.
- Assistance with personal care
- Help with medications
- Housekeeping
- Laundry
- On-site staff
- Recreation activities
- Around-the-clock supervision
- Security
- Social activities
- Three meals a day
Other Types of Eldercare
Assisted living is one of the many types of eldercare. Some types of eldercare provide services in facilities like assisted living does, others may provide care within the home.
How Much Does Assisted Living Cost?
The median cost of staying in an assisted living facility was $4,500 per person, per month in 2022, according to Genworth’s Cost of Care Survey.
But the cost can vary widely depending on which state — or city — you live in. For example, the Genworth survey found that the median monthly cost for assisted living care was $3,500 in Mississippi compared to $5,250 in California.
The median cost for New York was $4,580 per month, but for the New York City area specifically, it was nearly $6,000.
Assisted living is also a great option cost-wise for couples. While it can be expensive per person, it’s not double the price for two people living in the same unit. Typically, you would only need to pay for the second person’s medical assistance, meals and other miscellaneous expenses.
Does Medicare or Medicaid Cover Assisted Living?
Original Medicare — Medicare Part A and Part B — does not cover assisted living or any other type of long-term care. But it will cover the health services your Medicare coverage typically covers if you are in an assisted living facility.
Medigap — also known as Medicare Supplement insurance — helps pay for Medicare-covered services and items, so it cannot be used to pay for assisted living.
Most Medicare Advantage plans do not cover assisted living facilities. Check with your plan administrator to see if your specific plan does.
Medicaid may help pay for certain assisted living costs — but it does not pay for room and board. You must be eligible for Medicaid, meaning, you have exhausted your financial resources and have a low income.
Because Medicaid is a joint state and federal program, the rules for covering assisted living vary by state and some states may not cover assisted living.
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How to Pay for Assisted Living
In most cases, you will have to pay for all the costs associated with assisted living care. But there are some other options you may be able to consider.
You may also check with your local Area Agency on Aging about free counseling services, benefits and information about Medicaid eligibility and benefits in your area that may help you pay for an assisted living facility.
Who Qualifies for Assisted Living?
To be eligible for assisted living in most states, you typically need daily assistance with at least two activities associated with daily living.
- Bathing
- Getting dressed
- Going to the bathroom
- Grooming (shaving, brushing teeth, etc.)
- Making meals
- Rising out of bed
- Standing up or sitting down
- Walking
You typically don’t qualify for assisted living if you are bedridden or need memory care, major medical care or continuous supervision.
People with those qualities should consider skilled nursing facilities or other facilities for their specific conditions and needs, which would not be served in an assisted living facility.
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