When Medicare Covers Assisted Living and Home Care

For the many seniors today who need assisted living or in home care services, one of the biggest questions they often have about home care is how they can afford it. The cost of home care is also something that many families have questions about when it comes to making sure that their loved ones get the care that they need and deserve.

The expense of senior care can be overwhelming, which is where Medicare comes in. In certain situations, this program can help pay for eldercare. Here is everything you need to know about Medicare and what it may cover for your loved one.

So, What is Medicare?

Before diving into the coverage solutions available with Medicare, it is important to know exactly what Medicare is. Medicare is a national health insurance that all Americans receive when they turn 65. Adults who are under 65 and disabled can also enroll in Medicare on their own and enjoy this coverage without paying premiums.

In short, if your loved one is over 65, they have Medicare coverage.

There are four types of Medicare. When it comes to getting coverage for assisted living or home care, there are two options that may apply.

  • Medicare Part A- Also known as Hospital Insurance, this type of Medicare pays for inpatient hospital care including some skilled nursing and hospice, as well as prescribed home care, if it is required. Part A is offered without a premium for a majority of beneficiaries.
  • Medicare Part B- Also known as Medical Insurance, this type of coverage will include some home health care services but is mostly for outpatient physician and hospital services. This plan is not free. In 2018, it cost on average about $134/month.

What Does Medicare Cover?

Medicare is typically not helpful for seniors who need a long-term care solution. It is, however, helpful in short term care situations.

If your loved one needs to move into an assisted living community for an extended period of time, Medicare isn’t going to be very helpful. However, if your loved one needs assisted living or home care following a hospitalization, then Medicare can help.

Medicare is able to cover these types of short-term rehab stays in nursing homes or assisted living after they have been injured or hospitalized. In some situations, Medicare can also pay for therapy or rehab at home for a short period of time, when it is prescribed by a doctor.

The more you know about Medicare and what it can cover, the better. While no family ever wants to have a situation where their loved one needs to rely on Medicare for this type of coverage, the more prepared you are, the better.

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