Does Insurance Cover the Cost of Assisted Living?
It’s a simple question with a complex answer. Whether or not insurance will pay for assisted living depends on the type of insurance, the policy parameters, and the level of care needed. Here’s our primer on how insurance can help pay for long-term care.
Medicare The short answer is no—but there are a few exceptions. While Medicare does not pay for long-term care, it will cover short-term stays at approved skilled nursing facilities or rehabilitation centers following a hospital stay. The stay must generally be less than 100 days and come within 30 days of a related hospital discharge, and typically requires a copayment.
Long-Term Care Insurance Yes, long-term care insurance usually covers assisted living costs. Benefits typically take effect once someone can no longer perform a set number of activities of daily living—such as dressing, bathing and eating—or has cognitive impairment. Policies often include a predetermined waiting period between the time coverage is needed and when benefits kick in, generally a few months.
Veterans’ Benefits Qualifying veterans and their spouses can receive Aid and Attendance benefits for nursing home, assisted living or in-home care. Asset, income and medical requirements apply, and there is a lengthy application process through the Department of Veterans Affairs.
Medicaid Yes—but only in certain circumstances. Eligibility for Medicaid varies by state, but generally it provides support for low-income Americans who have few assets aside from a primary home and vehicle. Because most of assisted living is privately paid, Medicaid coverage also restricts choice of senior care facilities; some accept a small number of Medicaid residents, others none.
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