Author: Tiffany Stockton

Reviewed By: Kristi Bickmann

To calculate medical expenses for assisted living vs. rent, it’s important to understand the coverage included in the basic costs of each housing option. Some facilities have an all-inclusive flat rate for the services they offer, while others take an a la carte approach. It’s crucial to determine if specialized or standard care will better meet your needs, as this will significantly impact the overall cost of either option.

Basic assisted living fees often aren’t covered under long-term care insurance or Medicare unless your condition requires skilled nursing, constant supervision, or routine assistance with multiple activities of daily living (ADLs). Medical services received in a private home you rent are paid by both health care options. If you choose assisted living as the best option, plan ahead and know all the ways to pay for your costs.

Expenses in assisted living compared to renting

Medical expenses aren’t the only costs to consider for assisted living vs. rent. In assisted living, your main expense is the monthly fee, which covers your room, meals and basic services. Most times, standard medication management, nursing care and assistance with ADLs are all included. Assisted living facilities also offer amenities such as communal dining, social activities, transportation and housekeeping. This often contributes to a higher quality of life, which may reduce health concerns and health care needs.

When you rent independently, the primary cost is also your monthly fee, but that only covers where you live and maybe basic utilities. Beyond that, you need to consider other everyday expenses such as groceries, transportation and entertainment . Renting offers more flexibility for your living space and lifestyle, but it also means making separate arrangements for health care services.

What health care expenses are covered by insurance and Medicare?

Whether in assisted living or renting independently, health care costs are a shared consideration. In most cases, long-term care insurance and Medicare won’t cover custodial care as that’s considered a basic living expense. However, skilled nursing, hospice and in-home care are identified as qualified medical expenses. These types of care are fully covered if you’re in a private residence.

In assisted living, you need to be on a prescribed treatment plan following a hospital stay or have a licensed professional state you require assistance with at least two of the six ADLs. When you have a specific medical need, any services or items used to treat that condition are covered.

Talk to your doctor and consult with eldercare specialists to get personalized guidance based on your financial situation and health care needs. Then, create a comprehensive budget that includes all expenses so you’ll better understand how medical expenses factor into that financial assessment.