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Does Medicare pay for assisted living or memory care?

Generally, no. Medicare does not cover the room-and-board or custodial-care costs of assisted living or memory care. Medicare's coverage in senior car

Quick answer

Generally, no. Medicare does not cover the room-and-board or custodial-care costs of assisted living or memory care. Medicare's coverage in senior care is generally limited to short-term skilled nursing/rehab stays following a qualifying hospital admission, home health care ordered by a physician, and hospice care.

HomeQuestionsDoes Medicare pay for assisted living or memory care
Answer

Generally, no. Medicare does not cover the room-and-board or custodial-care costs of assisted living or memory care. Medicare's coverage in senior care is generally limited to short-term skilled nursing/rehab stays following a qualifying hospital admission, home health care ordered by a physician, and hospice care.

The detail behind the number

This is one of the most common and costly misunderstandings families run into, often discovering the gap only after a hospital discharge planner starts talking about 'next steps.' Whether a Medicare beneficiary qualifies for Medicare's skilled-nursing benefit at all often depends on a technical distinction -- whether the preceding hospital stay was billed as an inpatient admission or as 'observation status' -- so ask that question explicitly and in those exact words at whichever Milwaukee-area hospital system (Froedtert & MCW, Ascension Wisconsin, or Advocate Aurora/Advocate Health) is discharging your family member, since it directly affects what Medicare will and won't pay for afterward.

Related questions

Questions families ask

Does Medicare pay for assisted living or memory care?

Generally, no. Medicare does not cover the room-and-board or custodial-care costs of assisted living or memory care. Medicare's coverage in senior care is generally limited to short-term skilled nursing/rehab stays following a qualifying hospital admission, home health care ordered by a physician, and hospice care.

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