How well does Medicare support seniors who need assisted living, or does it fall short?

Question

DeeDee Whitlock · Accepted Answer

Medicare does NOT cover Assisted Living facilities at all, You will need a long-term Care policy to cover that expense.

Norman Smith · Answer

Assisted Living when Medically mandated, and signed off for not being able to perform a set amount of Activities of Daily Living, would not be handled by any Medicare or Supplemental policy to Medicare. Rather a separate policy for Long Term Care would need to be acquired in preparation for that period of time. Forbes Magazine ranks Bankers Life as having the best LTC PLANS available. I can assist you in finding a proper policy for you.

Answered by Norman Smith on July 17, 2025

Agent Licensed in FL & PA

Answered by Norman Smith Medicare Insurance Agent

Christopher Boyd · Answer

According to the 2025 Medicare And You Handbook, Long Term Care is not covered by Medicare, Medicare Supplement, or Medicare Advantage Plans. Long term care consist on non-medical Custodial Care performed in your Home, Adult Day Care Centers, Assisted Living, and Nursing Homes. The Medicare Book shows two general or common Nursing Home payment options: Medicaid Eligibility and Private Long Term Care Insurance.

Medicare Part A will pay for up to 20 days of Skilled Nursing with a partial co-pay for up to 100 days. This does not include Custodial Care.

Michael Denniston · Answer

Medicare does not cover assisted living. LTC (long Term Care) insurance does though. We help people with that too.

Marsha Reiniers · Answer

Medicare does not pay for the cost of assisted living. Medicare pays limited benefits for those discharged from the hospital needing skilled nursing care in a nursing home, or an in-patient rehab facility, and can pay for physical therapy at home or a walk in therapy practice - but again for a limited time. Medicare does not pay for long term care, the focus is on rehabilitation to help you return to your normal lifestyle, regain your strength, etc. The only insurance that truly pays for long term care, either at home, in an assisted living facility, or skilled nursing home, would be long term care insurance. So don't rely on Medicare to pay for true long-term care.

Answered by Marsha Reiniers on August 19, 2025

Agent Licensed in FL, GA, NC, PA, SC & VA

Answered by Marsha Reiniers Medicare Insurance Agent

Jennifer McDonnell · Answer

Medicare does cover 'skilled nursing care' but Medicare does not cover 'assisted living'.

Medicare will cover some 'home healthcare' immediatly following an extended hospital stay.

Best to consider either a 'short term home healthcare' or ' long term care' insurance policy if a person might need assistance in future years.  Important to buy insurance before the need.

Steve Thornton · Answer

It’s growing fast because of low premiums and extra benefits, but MA plans also come with networks and prior authorizations that Original Medicare doesn’t.

Bottom line: It’s not one-size-fits-all. The best plan depends on your health, doctors, and budget. Always compare before you decide!

Laura Shipman · Answer

Great question. Medicare will cover your medical expenses that they approve. However, paying for assisted living Medicare does not cover so you would need to look at additional coverage or pay out of pocket.

Answered by Laura Shipman on March 31, 2025

Agent Licensed in KS

Answered by Laura Shipman Medicare Insurance Agent

Daniel Weeks · Answer

Unfortunately, Medicare does not cover any assisted living care. The only thing Medicare pays for is Skilled Nursing care, which is after a hospital stay, recommended by a doctor with a plan of care in which medical care is needed and the patient is progressively getting better. Fortunately, my company provides such education and solutions to help pay for that cost.

Answered by Daniel Weeks on April 29, 2025

Broker Licensed in MN & WI

Answered by Daniel Weeks Medicare Insurance Agent

Steven Bleicher · Answer

I am sorry to tell you that statistics have consistently shown that every two out of three seniors above age 65 will, at one time or another find themselves in Adult Daycare, a Nursing home, in an Assisted Living or in an Alzheimer’s facility. Medicare pays for the 1st 100 days in all these places. But on day 101, if you had the presence of mind to have purchased a Long-Term Care plan, that will kick in next and was a terrific idea. These costs are continuing to escalate due the inflationary pressures. If you are in your late 50’s or early 60’s, this would be the best time to see if you and your partner can each qualify and afford LTC?

Answered by Steven Bleicher on June 16, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Joseph Peck · Answer

In 1998, Medicare passed a law that said that medicare can no longer cover Home Health care, Assisted living and/or Nursing home. It will cover for up to 100 days for rehab, but cannot go past that. Thats the reason its a good idea to look into plans that can help take care of those concerns before it is needed. Very few companies do that now. I happen to be one who does.

Answered by Joseph Peck on August 18, 2025

Agent Licensed in MI, AL, CO, KS & TN

Answered by Joseph Peck Medicare Insurance Agent

Rick Boyd · Answer

Medicare does not pay for assisted living. You will need to look towards long term care insurance, or other types of additional care coverage.

Satoshi Aoki · Answer

Medicare will pay for your medical care, but it does not cover room, meals, or personal care in assisted-living facilities, so seniors usually need other resources (private funds, long-term-care insurance, or Medicaid) to pay those costs.

Answered by Satoshi Aoki on July 7, 2025

Agent Licensed in CA

Answered by Satoshi Aoki Medicare Insurance Agent

Theodore Carpenter · Answer

Medicare was never designed to cover long-term care. You pay nothing for an acute illness for 20 days, and then the copay is $150 per day. If it's determined that you are not showing improvement, Medicare will not cover it at all.

Answered by Theodore Carpenter on August 25, 2025

Broker Licensed in IA, AZ, IL & TN

Answered by Theodore Carpenter Medicare Insurance Agent

Diane Poythress · Answer

Medicare does not generally cover the costs of assisted living. While Medicare provides coverage for some skilled nursing care in certain situations and some Medicare Advantage plans may offer limited assistance with non-medical services, it primarily focuses on acute medical care, not long-term custodial care. 

Medicare primarily focuses on acute medical care and rehabilitation, while assisted living facilities mainly provide custodial care, which includes help with daily living activities, medication management, and supervision. This is why you need to have a plan in place for yourself in case you need assistance.

Janet Cruz · Answer

Medicare does not cover assisted living—it actually falls short when it comes to help with high costs of assisted living. If assisted living might be needed planning ahead through Medicaid or other insurance is crucial. Medicare it’s primarily designed for medical care, not daily living support, like assisted living.

Answered by Janet Cruz on June 9, 2025

Broker Licensed in FL

Answered by Janet Cruz Medicare Insurance Agent

Helena Foutz, RSSA · Answer

Medicare is health insurance and does not pay for assisted living.  It is a good idea to get either a long-term care (LTC) plan or a hybrid life insurance plan with an LTC rider.

Christopher Orr · Answer

No , long-term care isn't covered by medicare it's covered by private pay , long-term care insurance or medicaid

Aaron Lewis · Answer

Medicare does not cover the cost of assisted living facilities .Medicare primarily covers medical services and short term care rehabilitation stays in skilled nursing facilities

Jason Vallejos · Answer

Medicare offers very limited benefits for members in assisted living. However, there are Meddicare Advantage Plans to consider for folks in assisted living. Also, Medicaid and Long-Term Care best cover assisted living needs.

Answered by Jason Vallejos on May 5, 2025

Broker Licensed in CA, AZ, CO & 11 other states

Answered by Jason Vallejos Medicare Insurance Agent

Gary Henderson · Answer

No, Medicare does not cover the costs of assisted living facilities. Medicare primarily covers medical services like doctor visits, hospital stays, and skilled nursing care, but not the general costs associated with living in an assisted living facility, such as room and board, housekeeping, or assistance with daily activities

Answered by Gary Henderson on April 19, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent

Mike Henry · Answer

Medicare doesn’t provide assisted living. That’s only provided through long term care. Also through certain life insurance policies

Marcie Barnes · Answer

Assisted living is not a covered benefit of Medicare.  You would need a different type of insurance for that.  Such as long-term care or an Indexed Annuity with a living benefit.

Contact me for more information Marcie Barnes

Douglas Carney · Answer

As a health insurance broker, I understand the importance of clear answers for seniors exploring assisted living options. Unfortunately, Medicare does not cover the core costs of assisted living, such as room and board or custodial care like help with daily activities. However, it shines in covering medically necessary services—think doctor visits, hospital stays, or skilled nursing care—that seniors in assisted living may need. Some Medicare Advantage plans even offer expanded benefits, like in-home support or adult day care, which can ease the financial burden. While Medicare alone isn’t a complete solution, combining it with Medicaid, long-term care insurance, or VA benefits can create a robust safety net.

Answered by Douglas Carney on May 11, 2025

Broker Licensed in FL, GA, NC, OK & TX

Answered by Douglas Carney Medicare Insurance Agent

Tonya Mowan · Answer

Assisted Living is an area that Original Medicare and Part B do not cover, however there may carriers that have some assistance or an individual can use savings, have a long-term care insurance coverage, or assistance form programs like Medicaid to help cover the cost.

Answered by Tonya Mowan on May 12, 2025

Agent Licensed in AR, MO & OK

Answered by Tonya Mowan Medicare Insurance Agent

Jessie Rhodes · Answer

So when it comes to the assisted living I would say that it does fall short due to the fact it leaves that 20% cost that is unknown to the client but that is where a great Agent will advise the clients on the other option that will help cover those costs.

Answered by Jessie Rhodes on July 26, 2025

Agent Licensed in TX, AL, AR & 24 other states

Answered by Jessie Rhodes Medicare Insurance Agent

Kelly Allen · Answer

Does Medicare support Seniors who need assisted living - not directly. I would recommend contacting your Local Council on Aging Resource Center. They typically have people that can assist you in locating housing and could possibly assist with qualifying for housing as well. I hope this helps.

Answered by Kelly Allen on August 18, 2025

Broker Licensed in FL, AR, AZ & 21 other states

Answered by Kelly Allen Medicare Insurance Agent

Gregory Gudis · Answer

Medicare doesn't pay for a short-term stay in assisted living since assistance with personal care tasks isn't considered medically necessary. However, Medicare does pay for medically necessary short-term care in a nursing home

Answered by Gregory Gudis on April 14, 2025

Broker Licensed in AZ, CO, CT & 16 other states

Answered by Gregory Gudis Medicare Insurance Agent

Christina Bowman · Answer

Medicare falls short. It does not pay for assisted living. Medicaid does . Should you not qualify for Medicaid a long term care policy can relieve your burden.

Mark Szymanski · Answer

In general, Medicare will not cover assisted living costs. While Medicare does not cover assisted living, it will continue to pay for all approved services under Parts A and B—such as hospital stays, doctor visits, procedures, and screenings.

Answered by Mark Szymanski on April 10, 2025

Agent Licensed in PA & NJ

Answered by Mark Szymanski Medicare Insurance Agent

How well does Medicare support seniors who need assisted living, or does it fall short?

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How well does Medicare support seniors who need assisted living, or does it fall short?

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