Medicare and Medicare Advantage don’t cover assisted living, but in 2020, some Medicare Advantage plans are offering benefits that will help seniors continue living independently.
These benefits vary by plan and locality but may include such things as nutrition services, home modifications, and adult daycare.
Medicare Advantage Plans and Assisted Living
All Medicare Advantage plans offer the same Part A and B benefits as Medicare. Premiums, copays, coinsurance, and the network of doctors will vary from one program to another.
Some Advantage plans include prescription, vision, dental, and hearing coverage. In the past, neither Medicare nor Part C has covered any type of long-term care, other than skilled nursing care after a hospital stay.
In 2019, the Centers for Medicare and Medicaid Services announced that Advantage plans could begin offering certain long-term care benefits. Although, CMS left it up to the insurance companies to decide which benefits to offer and which programs would include them.
Several new benefits may be part of the 2020 Medicare Advantage plans.
Home Improvement for Safety
Medicare Advantage plans help with the cost of grab bars, ramps, and other home changes that improve safety.
These improvements could prevent falls, hospitalizations, and allow people to continue living at home.
Part C plans can offer telehealth benefits. Telemedicine allows enrollees to have a video conference with a doctor.
Also, telehealth is helpful to people managing chronic health or those having a hard time getting to the doctor’s office.
Personal Care Services
While Medicare typically doesn’t cover in-home care, some Advantage plans now include assistance with personal tasks like bathing, dressing, and preparing food.
Assistance can be beneficial to people who need extra help temporarily while recovering from an illness or injury. But, plans will limit the number of days or hours included in this benefit.
Transportation and Meals
Medicare Advantage plans offer rides to medical offices. However, there may be limits to the number of dates for which a trip is available.
Also, plans may offer meal delivery for people who are homebound and unable to prepare food. These deliveries may have limitations to a certain number of meals after a hospital stay.
Adult Day Care
Also, Medicare Advantage plans may include adult daycare benefits. Adult daycare provides a stimulating and social environment while giving regular caregivers a respite.
Policies may limit the number of days or the frequency of adult daycare use.
Over the Counter Benefits
Some plans may offer benefits for over the counter medications, like Tylenol, vitamins, or allergy medicine. Benefits like this are a big help for people who rely on “over the counter” drugs to manage pain or chronic conditions.
Does Medicare Pay for Assisted Living
Despite these new benefits, one essential rule about Medicare and long-term care remains: Medicare does not pay for the room, board, and aid with activities of daily living in an assisted living facility. Medicare covers only medical costs.
With ALF costs averaging $45,000 a year, paying for an ALF can be hard.
How to Pay for Assisted Living
In a perfect world, you have a healthy amount of savings, plus retirement income, that can pay ALF costs. In the real world, that’s often not the case.
Here are some of the ways people pay for assisted living:
- Long-term care insurance.
- Selling or borrowing against the family home.
- Converting term life insurance to a universal or whole life policy
- Life settlements, or selling a life insurance policy for cash
- Equity key agreements, which allow a homeowner to receive some money in exchange for a percentage of a home’s future appreciation
Finding a Medicare Senior Assisted Living Facility
There are several ways to locate an ALF in your area. An internet search will give you an overview of your local options.
Friends and family with the first-hand experience may be able to provide you with recommendations. Plan to visit any AFL; learn more about costs, activities, meals, and whether the facility is a good fit.
Is there financial assistance for assisted living
There’s no financial aid that targets ALF’s, but there are benefits that can boost monthly income or reduce costs, making an ALF easier to afford.
- Aid and Attendance; this benefit is available to eligible veterans and their spouses. Eligibility is open regardless of whether they get hurt in the line of duty or not.
- Medicaid, the state-run insurance program for people with low incomes, can help pay for assisted living in some states. Also, it will pay for nursing home care.
- Medicaid eligibility can reduce the amount you pay out of pocket for healthcare, prescriptions, and premiums.
How much does Medicare cover for assisted living
While Medicare won’t pay for an assisted living generally, it may pay for certain medical services—such as doctor’s appointments—you receive onsite at an assisted living facility.
Find out More on Medicare Advantage Plans
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