What are my Medicare options if I move into a Continuing Care Retirement Community (CCRC)?

Question

Larry Dalton · Accepted Answer

This is called long-term care services. Medicare does not typically cover long-term care expenses associated with retirement communities. However, Medicare Part A & B covers medically necessary services such as physician visits, hospitalization, and some DME services, which depend upon the type of facility and how it is classified by the state.

Answered by Larry Dalton on May 5, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Misty Bolt · Answer

It depends on the county and zipcode that you live in. Also want to make sure the doctors  and pharmacy on staff at CCRC are in the network of which plan you choose.

David Silver · Answer

If you move into a Continuing Care Retirement Community (CCRC), you can keep Original Medicare (Parts A & B) with a Medigap plan and Part D for prescriptions, or choose a Medicare Advantage (Part C) plan that may include drug coverage and extra benefits. While some CCRCs may suggest certain plans or have preferred providers, you are free to select any Medicare option that best fits your needs. It’s important to review your coverage as your healthcare needs evolve over time.

Answered by David Silver on May 6, 2025

Broker Licensed in FL, NJ & NV

Answered by David Silver Medicare Insurance Agent

Fred Manas · Answer

What Medicare Does Cover in a CCRC:
Skilled Nursing Care: Medicare may cover medically necessary skilled nursing care in a CCRC's healthcare center, especially if it's a short-term stay following a hospital stay. 
Physician Services: Medicare covers doctor visits and other medically necessary services provided within the CCRC. 
Hospital Stays: If a resident needs to be hospitalized, Medicare can cover those costs. 
Medical Supplies: Medicare may cover the cost of certain medical supplies, like wheelchairs or walkers, if a resident needs them.
 
What Medicare Does Not Cover in a CCRC:
Room and Board: Medicare does not cover the cost of housing, meals, or non-medical care in the CCRC. 
Assisted Living Services: Medicare does not cover services like bathing, dressing, or transferring, which are typically part of assisted living. 
Long-Term Nursing Home Care: While Medicare may cover short-term skilled nursing care, it generally doesn't cover long-term stays in a CCRC's nursing home unit. 
Factors to Consider:
CCRC Contract: The type of residency contract you have with the CCRC will impact how costs are handled when skilled nursing care is needed. 
Long-Term Care Insurance: You may have long-term care insurance that can help cover costs beyond what Medicare covers. 
Medicaid: Medicaid may be an option for low-income individuals who qualify for long-term care. 
Medicare Part A and Part B: Medicare Part A covers hospitalization and skilled nursing care, while Part B covers doctor visits and outpatient care. 
Medicare Advantage: Medicare Advantage plans may offer additional benefits, but they still generally don't cover long-term care expenses.

Sam Silva · Answer

* You can keep Original Medicare (A & B).
* Medicare Advantage depends on plan network—check local coverage.
* You can keep Part D, but CCRCs may offer their own drug plan.
* Medigap can stay, but some CCRCs may not accept it for billing.

Check with the CCRC on how they coordinate with Medicare.

Glenn Alterman · Answer

Nothing changes for you as Medicare is your health insurance.  It does not pay for for your housing

Dominic Javier · Answer

PACE - Program of All-inclusive Care for the Elderly (PACE) should be an option. PACE is a Medicare and Medicaid program offered in many states that allows people who need a nursing home-level of care to remain in the community, like home, apartment, or other appropriate setting. PACE covers all Medicare and Medicaid -covered care and services the team of healthcare professionals decides are necessary to improve and maintain your health.

Answered by Dominic Javier on May 5, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent

Joseph Smith · Answer

As far as what Medicare will pay for, Medicare Part A will pay for a portion of care for up to 100 days, but won’t pay any portion after 100 days. As far as options for Medicare plans? If the CRRC you are moving into is outside of your Medicare Advantage Plan’s service area, you will have a special election period to change to another Medicare Advantage Plan

Answered by Joseph Smith on May 9, 2025

Agent Licensed in SC, MD & NC

Answered by Joseph Smith Medicare Insurance Agent

What are my Medicare options if I move into a Continuing Care Retirement Community (CCRC)?

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What are my Medicare options if I move into a Continuing Care Retirement Community (CCRC)?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

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Medicare Agents HubA non-government resource website

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A non-government resource website