Medicare’s Role in the Lives of Assisted Living Residents

Most residents of assisted living communities pay for their housing out-of-pocket. Medicare, the national insurance program, is available to all U.S. citizens when they turn 65. Medicare does not cover room and board or activities of daily living (medication management, help w eating, dressing, etc.).  However, Part B of the plan will pay for services (therapies – physical, occupational, speech) which help in keeping a senior eligible to continue living in the home they’ve chosen. The services must stem from an incident requiring hospitalization such as a fall (the severity of falls increase with age). Medicare’s Part A (for hospital and nursing home stays), Part C and D apply to residents in assisted living communities in the same way they apply to people living elsewhere. They all must pay certain deductibles before coverage begins.

Part B of Medicare is the most pertinent to seniors living  in independent or mostly independent communities. The services it pays for reduce the likelihood of a senior having to move to a nursing home or back to the hospital (both of which are significantly more expensive than assisted living). Remaining in familiar settings benefit seniors in particular by avoiding transfer trauma.

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