Does Medicare cover assisted living?
When families first begin researching senior living options, one of the first questions they ask is:
“Does Medicare pay for assisted living?”
Unfortunately, the short answer is no—Medicare does not cover the cost of assisted living. This can come as a surprise, especially since Medicare is often associated with healthcare support for seniors. But assisted living falls outside the types of services Medicare is designed to cover.
Here’s what you need to know—and what other options might be available to help.
What Is Assisted Living, and Why Doesn’t Medicare Cover It?
Assisted living communities provide housing, meals, social activities, and help with daily tasks like:
- Bathing and dressing
- Managing medications
- Getting to appointments
- Housekeeping and laundry
While this support improves quality of life, it’s considered custodial care—not medical care. Medicare only pays for medically necessary services, not room and board or non-medical personal assistance.
That’s why assisted living, unlike a hospital or rehab center, typically isn’t covered.
What Does Medicare Cover?
Medicare can still play a role in a senior’s care—but not in paying for where they live. Here’s what it can cover:
- Hospital stays
- Doctor visits and preventive care
- Short-term skilled nursing care (after a qualifying hospital stay—up to 100 days)
- Some in-home health services (if prescribed by a doctor)
- Physical, occupational, and speech therapy
- Hospice care (usually provided at home or in a hospice facility)
So, if your loved one moves into an assisted living community and needs a visiting nurse or therapist, Medicare may cover those specific medical services—but not the assisted living itself.
Are There Any Exceptions?
Not for room and board. But some communities work with third-party providers to offer Medicare-covered services on-site, such as:
- Visiting physicians
- Rehabilitation therapists
- Mobile labs or X-rays
This can help reduce hospital visits and make care more convenient—but it doesn’t reduce the monthly assisted living cost.
What About Medicaid?
While Medicare doesn’t cover assisted living, Medicaid might—but only for eligible individuals and only in certain states.
Each state runs its own Medicaid program, and many offer waivers or special programs to help low-income seniors afford assisted living or personal care. For example:
- In New York, the Assisted Living Program (ALP) can cover costs for qualifying residents.
- In other states, Home and Community-Based Services (HCBS) waivers may help pay for care within certain facilities.
Eligibility is based on income, assets, and care needs—and spots can be limited.
Final Thoughts
Medicare is an essential resource for healthcare in retirement—but when it comes to paying for assisted living, families usually need to look elsewhere. Understanding the limits of coverage early on can help avoid surprises and create a more realistic plan for long-term care.
Need help navigating the financial side of senior care?
Our team can help you explore your options—from Medicaid eligibility to long-term care planning. Reach out today for a free consultation.