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Medicare and assisted living explained

Medicare has different rules when it comes to coverage, but what happens if you need assisted living?

Medicare insurance card with American flag

Medicare does not cover long term care like assisted living facilities, but it can cover situations which require nursing home stays.

There are various services that are covered for those receiving Medicare in their living situations, but long term care is not one of them.

If certain circumstances are met, there may be coverage similar to that.

If a short term stay is required at an inpatient care skilled nursing facility then that is covered.

Medicare: 2022 deductible

When in patient care is covered by Medicare explained

Medicare covers up to 100 days per benefit period in a skilled nursing facility.

This will only be covered if a doctor decides you need this type of care and service.

Assisted living facilities is not counted because there is no intensive medical care happening.

You need to be formally admitted as a hospital patient for at least three days.

Observation and outpatient care do not count as the three days.

In order for care to be covered at the skilled nursing facility, it needs to be Medicare certified.

A doctor needs to decide that you require that type of care, and your reason for being there must be to treat that condition.

Care needs to start within 30 days of you leaving the hospital.

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Not retired? You can still apply for Medicare

What will be covered by Medicare?

Up to 100 days per period are covered.

The first 20 days are covered in full.

The next 80 are covered partially.

You’ll need to pay $194.50 per day in coinsurance.

If you go past 100 days, you must pay each day in full.

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