.png&w=256&q=75){kind=small}
Do Medicare Advantage Plans Cover Assisted Living?
Date Updated: July 26, 2024
Written by:
Rachel Lustbader is a writer and editor with a background in healthcare and technology. Her work has been published on websites including HealthCare.com, BiteSizeBio.com, BetterHelp.com, Caring.com, and PayingforSeniorCare.com. She studied health science and public health at Boston University.
Both of Rachel’s grandmothers had very positive experiences in senior living communities, and Rachel saw firsthand the impact that kind, committed caregivers and community managers can have on seniors’ and their family members’ lives. With her work at Caring, Rachel hopes to help other families find communities, caregivers, and at-home products that benefit elderly loved ones and make life less stressful for family caregivers
Medicare Advantage Plans do not cover assisted living. However, depending on the individual policy, a plan could help seniors pay for some of the services offered by residential care communities.
Medicare Advantage
Of the 60 million American seniors enrolled in Medicare in 2023, 51% also have Medicare Advantage plans, an increase of 8% from 2022. With so many older adults choosing the additional coverage offered by Medicare Advantage, beneficiaries must understand what services their plan covers. When these insurance plans fall short of covering the full costs, seniors need to find other ways to pay for assisted living.
What Medicare Advantage covers
Otherwise known as Medicare Part C, Medicare Advantage is a health insurance policy for seniors aged 65+. In 2024, there are more than 8,500 Medicare Advantage plans on offer, with the average senior having 287 to choose from for their county.
Advantage plans must offer the same benefits as Medicare Parts A and B, including:
- Skilled nursing care
- Outpatient surgery
- X-rays
- Lab tests
- Emergency transportation
- Screenings for certain conditions, such as diabetes and cancer
- Mobility aids and medical equipment
In addition, these policies include extra benefits designed to help seniors remain in their own homes. Benefits vary by policy but may include the following:
- Dental and vision care
- Prescription drugs
- Transportation to medical appointments
- Nutrition services
- Telehealth services
- Personal care services, including assistance with dressing, bathing and meal preparation
Other ways to pay for assisted living
Although Medicare Advantage doesn’t cover assisted living directly, seniors can potentially use it to help pay for some services, especially if they can establish that their homes are within a residential care setting. However, fees for bed and board, organized activities and meals are not covered by these plans. For these expenses, assisted living residents must look for other ways to finance their stay.
With Medicare Advantage not covering an actual stay in an assisted living community, seniors may have to consider financing options, such as:
- Medicaid and Medicaid waivers
- Cashing in on life insurance policies
- Selling their home
- Long-term care insurance
- Veteran benefits
- Retirement benefits such as IRAs, reverse mortgages, annuities or IRAs
- Assistance from charitable organizations, such as local churches, nonprofits and support groups