Medicare, Assisted Living and You

Medicare Part A

Medicare Part A is "hospital insurance." It helps your loved pay for her time in a hospital or skilled nursing facility. It generally covers the first 100 continuous days in a facility and offers some of the following benefits:

• Skilled care
• A semi-private room
• Meals
• Tests
• Physical, occupational and speech therapy
• Medical equipment

Medicare Part A is provided free of charge to individuals who have been legal residents of the U.S. for at least five years, are aged 65 or older, and who's self or spouse has paid Medicare taxes (a part of payroll taxes) for a minimum of 10 years. Other seniors may opt in to the program for a monthly premium. Learn more about Medicare and assisted living in the section, "Is There Such Thing as Medicare Assisted Living?" below.

Medicare Part B

Medicare Part B is often referred to as "supplemental medical insurance." It provides medical coverage for services associated with visits to a physician's office, including some of the following:

• Durable medical equipment
• Prosthetics
• Eyeglasses
• Physician visits
• Outpatient hospital procedures
• Ambulance transportation
• Chemotherapy
• Renal Dialysis

As a supplemental insurance, your loved one will be responsible for a monthly premium ($110.50 in 2010) as well as a yearly deductible ($155 in 2010). Participation is entirely voluntary.

Some benefits covered under Medicare Part B can apply to your loved one's stay in an assisted living facility. While it won't drastically reduce her yearly assisted living rates, it will help with doctor's visits; walkers, wheelchairs and other equipment; eyeglasses and some medical treatments.

Is There Such Thing as Medicare Assisted Living?

In a word: no. Unfortunately, the Centers for Medicare and Medicaid Services (CMS) regulates Medicare coverage to include benefits for services provided in physician's offices, hospitals, clinics and skilled nursing facilities.

Choosing an assisted living facility for your loved one provides a good deal of freedom and personal expression, but because the majority of services they provide are considered custodial (not medical in nature), they are not covered. Similar stays in skilled nursing facilities , however, can be covered. For help deciding which setting is most fitting for your loved one, see our article, "Nursing Home vs. Assisted Living Facility."

Fortunately, CMS does help many seniors by offering beneficiaries Medicaid assisted living rates at specific facilities. For more information, see our Medicaid Assisted Living article or speak to an elder care advisor for personalized information. Also, get more tips on financing your assisted living.

Find the Best Assisted Living Rates

Once you are comfortable with the type of care you want and the type of coverage your loved one is eligible for, our expert elder care advisors can help you translate that into a short list of assisted living facilities in your area. Just call the number at the top of this page and an advisor will happily assist you. They'll be there to walk you through the whole process, free of charge. If you're upset to learn that there are no Medicare assisted living facilities, they will do everything they can to connect you with the coverage you need so that you can make a decision that's good for your loved one and works with your budget.