Medicare does not pay for assisted living facilities
Original Medicare (Parts A and B) does not cover the cost of living in an assisted living facility. This includes room, board, meals, laundry, or the personal care services that make assisted living different from a hospital or nursing home. If you move to an assisted living facility, you pay the full cost yourself — typically $4,500 to $6,000 per month, though this varies widely by location and the level of care you need.
Medicare will pay for skilled nursing care if you need it, but only in a nursing home (also called a skilled nursing facility), and only after a hospital stay of at least three days. Assisted living is not the same as skilled nursing. The difference matters because it determines what Medicare will and will not cover.
Some people confuse assisted living with other types of care because the names sound similar. Understanding which type of facility you are considering — and what Medicare actually covers there — can save you from unexpected bills.
Key Takeaways
- Medicare Part A does not cover assisted living facilities, room and board, or personal care services in any setting outside a hospital or skilled nursing home.
- Medicare Part A will cover a skilled nursing facility for up to 100 days after a hospital stay of at least three days, but assisted living does not may have access to as skilled nursing.
- Medicaid, not Medicare, is the program most likely to help pay for assisted living, but only if you meet income and asset limits that vary by state.
- Long-term care insurance, personal savings, and family support are the main ways people pay for assisted living when Medicare does not cover it.
- Some assisted living facilities offer memory care units that may be covered under different rules if skilled nursing is involved, so ask the facility directly what Medicare will cover in your specific situation.
What Medicare Part A covers instead of assisted living
Medicare Part A covers inpatient hospital care and skilled nursing care in a nursing home — but only under specific conditions. You must have been admitted to a hospital as an inpatient (not treated in the emergency room and sent home) and stayed at least three nights. After you leave the hospital, Medicare Part A will then pay for up to 100 days in a skilled nursing facility if a doctor says you need skilled care to recover.
Skilled nursing means care that requires a nurse or therapist — wound care, intravenous medications, physical therapy, or monitoring after surgery. It does not mean help with bathing, dressing, meals, or taking pills by mouth. Assisted living provides the second type of care, which is why Medicare does not cover it.
If you go to a skilled nursing facility after a hospital stay, Medicare Part A pays the full cost for the first 20 days. From day 21 to day 100, you pay a daily copay (the amount changes each year). After 100 days, you pay all costs yourself.
Why Medicaid, not Medicare, may help with assisted living costs
Medicaid is a different program from Medicare, run by your state rather than the federal government. While Medicare does not cover assisted living, some state Medicaid programs do — but the rules are strict and vary by state.
To receive Medicaid help with assisted living, you must meet income and asset limits. In most states, your monthly income must be below a certain threshold (often around $2,000 to $2,500, though this changes yearly), and your savings and other assets must be below a limit (often around $2,000). These numbers differ by state, and some states are more generous than others.
Even if you meet the income and asset limits, not all assisted living facilities accept Medicaid. Some facilities are private-pay only. Before you move to an assisted living facility, ask whether it accepts Medicaid and what the process is to enroll. You can also contact your state Medicaid office or your local Area Agency on Aging to learn what assisted living coverage, if any, your state offers.
How to pay for assisted living when Medicare does not cover it
Most people pay for assisted living through a combination of methods. Some use personal savings or retirement accounts. Others rely on family members to contribute. Long-term care insurance, if purchased before you need care, can cover part of the cost — but policies vary widely in what they pay and for how long.
A few assisted living facilities offer a continuing care retirement community (CCRC) model, where you pay a large upfront fee and then a monthly fee. This can lock in costs and may provide you access to higher levels of care (like nursing home care) if your health declines. However, CCRCs are expensive and not right for everyone.
If you have limited income and few assets, Medicaid is your best option. If you do not meet Medicaid limits but cannot afford assisted living on your own, talk to a social worker at your hospital or your local Area Agency on Aging. They can sometimes connect you with local nonprofits or programs that help bridge the gap.
The difference between assisted living and skilled nursing facilities
An assisted living facility is a residential setting where staff help with daily activities like bathing, dressing, meals, and medication reminders. You have your own room or apartment. There is usually a nurse on site, but not 24-hour medical care. Assisted living is for people who need help with daily tasks but do not need skilled medical care.
A skilled nursing facility (nursing home) has nurses and therapists on staff 24 hours a day. It provides medical care, wound care, therapy, and monitoring. It is for people recovering from surgery or illness, or those with serious medical conditions that require daily professional care.
Medicare pays for skilled nursing facilities (under the conditions described above) but not for assisted living. If you are trying to decide which type of facility you need, ask your doctor. Your doctor can tell you whether you need skilled care (which Medicare may cover) or personal care (which you pay for yourself).
What to ask your doctor and the assisted living facility
Before you move to an assisted living facility, have a conversation with your doctor about what level of care you actually need. Ask: "Do I need skilled nursing care, or do I need help with daily activities?" Your doctor's answer will tell you whether Medicare might cover any part of your care.
When you contact an assisted living facility, ask these questions directly: "Does Medicare cover any services here?" "Do you accept Medicaid?" "What is included in the monthly fee, and what costs extra?" "What happens if my health declines and I need more care?" Get the answers in writing.
If the facility says Medicare covers something, ask them to explain exactly what and for how long. Some facilities may offer skilled nursing services on site (like wound care), which Medicare might cover separately — but the assisted living room and board itself will not be covered.
When to contact your state Medicaid office or Area Agency on Aging
If you think you might not be able to afford assisted living, contact your state Medicaid office before you move. They can tell you whether your state covers assisted living under Medicaid and what the income and asset limits are. You can find your state Medicaid office through the Centers for Medicare & Medicaid Services website or by calling 1-800-MEDICARE.
Your local Area Agency on Aging can also help. They know about programs in your area, can connect you with social workers, and sometimes know about local resources that help pay for assisted living. You can find your local Area Agency on Aging by calling the Eldercare Locator at 1-800-677-1116 or visiting their website.
If you are already in a hospital or nursing home and worried about what happens next, ask to speak with a social worker or discharge planner. They can help you understand your options and what you can afford.
Frequently Asked Questions
Can Medicare pay for assisted living if I have a medical condition?
No. Medicare does not cover assisted living facilities or the services provided there, regardless of your medical condition. If you need skilled nursing care (wound care, therapy, medical monitoring), Medicare may cover a nursing home after a hospital stay. But assisted living itself — the room, meals, and personal care — is never covered by Medicare.
What if I need memory care for dementia — does Medicare cover that?
Medicare does not cover memory care units in assisted living facilities. However, if you have dementia and also need skilled nursing care (such as wound care or therapy), Medicare may cover a skilled nursing facility. Ask your doctor whether you need skilled care, and ask the facility what services are included in memory care.
Will Medicare pay if I move to assisted living after a hospital stay?
Medicare will not pay for the assisted living facility itself. However, if your doctor says you need skilled nursing care after your hospital stay, Medicare may pay for a skilled nursing facility for up to 100 days. After that, you would need to pay for assisted living yourself or use Medicaid if you meet the requirements.
How do I know if my state Medicaid covers assisted living?
Call your state Medicaid office or visit their website — the rules vary by state. Some states cover assisted living under Medicaid; others do not. You can also call 1-800-MEDICARE and ask to be transferred to your state Medicaid office, or contact your local Area Agency on Aging for information about programs in your area.
What if I cannot afford assisted living and do not meet Medicaid limits?
Talk to a social worker at your hospital or your Area Agency on Aging. Some communities have nonprofits or local programs that help bridge the gap. You might also explore whether a continuing care retirement community, shared housing, or staying at home with in-home care is possible. A social worker can help you think through your options.