Many senior citizens prefer to live in a community with others who are close in age. Living in a big home in your senior years can become a hassle and expensive. If you are looking for a change, you could consider moving to an independent living facility. But does Medicare cover senior independent living?

Medicare is America’s health insurance program for seniors 65 years and older or others who qualify earlier due to disability. Senior independent living does come with a cost, so let’s discuss below if Medicare will cover any of the expenses.

What is senior independent living?

Senior independent living is a housing arrangement solely for senior citizens, primarily those who are 55 years and older. Typically, this type of housing is either a single-family home or an apartment. But what makes this type of living different is you are in a community with other independent living seniors with easy navigation around the facility.

You do not have to worry about house or yard maintenance, as the facility will take care of those tasks. Within these communities, they typically offer amenities, services, and activities for their residents. For example, many include a fitness center, tennis courts, swimming pools, and spas. Other services may include basic housekeeping, laundry services, and even beauty and barbershops.

The seniors that live in independent living facilities do not need assistance with daily activities, such as bathing, dressing, and eating. However, if you do require custodial care, you can consider hiring an in-home nurse separately.

All of this might sound great to you, but how will Medicare cover your stay?

What does Medicare cover?

There are two parts of Medicare: Part A and Part B.  Medicare Part A covers hospital inpatient expenses, and Part B is outpatient coverage. Medicare covers healthcare services that fall under these two parts and are deemed medically necessary by your doctor.

Part A

As mentioned above, Medicare Part A is your inpatient coverage. Part A covers things like your hospital room, three meals, any medications administered to you, and any necessary lab services in the hospital. Medicare Part A covers your post-hospital expenses, such as your stay at a skilled nursing facility.

It’s common for seniors to stay at a skilled nursing facility after being discharged from the hospital. Medicare Part A will pay in full for a 20-day stay at a skilled nursing facility if you were an inpatient for at least three days. A skilled nursing facility stay is considered short-term care.  After day 20, you will have a copay of $185.50 for days 21 through 100 in 2021.

Part B

Medicare Part B covers outpatient services, such as ambulance rides, durable medical equipment, doctor’s visits, select vaccinations, home health care, and much more.

What Medicare doesn’t cover

Medicare only covers short-term care, never long-term care, such as staying at a nursing home and a long-term care facility. Unfortunately, a senior independent living facility is considered long-term care; therefore, Medicare will not cover your stay at this type of facility.

Medicare will not cover your rent, utilities, or custodial care. However, if you receive care inside a long-term care facility and the doctor is willing to bill Medicare, Medicare will provide coverage if your service is deemed medically necessary by the doctor.

Alternative coverage for independent living

Many Medicare beneficiaries purchase long-term care insurance to help pay for their stay at a senior independent living facility. Long-term care insurance is something you should consider purchasing whenever you are in your 50’s because you can be denied coverage if you wait until you are ready to move.

It’s common for seniors to use their retirement savings, health savings account (HSA) funds, or Medicaid to help cover long-term care costs. You will want to shop for long-term care insurance wisely, as some provide many benefits, and others may only cover you in a nursing home.

Summary

Medicare covers short-term care that is deemed medically necessary by a doctor. However, Medicare does not cover long-term care at a senior independent facility. If you are looking for long-term care options, do not wait until the last minute. Begin your search years in advance and consider purchasing insurance to help cover your out-of-pocket costs.