What It Is
Residence in an assisted-living facility
What's Covered
Neither Medicare Part A, Medicare Part B, nor any Medicare Part C Medicare Advantage plan (also known as a Medicare Advantage plan) covers residence in an assisted-living facility.
Tip: In limited circumstances, Medicare Part B or a Medicare Part C Medicare Advantage plan can cover short-term, in-home healthcare from an outside agency delivered to a patient who resides in an assisted-living facility.
What Medicare Pays
Medicare pays nothing for residence in an assisted-living facility.
Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:
The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?
The care must be performed or delivered by a healthcare provider who participates in Medicare.
