Original Medicare does not pay for assisted living residence fees, room and board, or help with daily activities when that help is the only care a person needs. Medicare classifies this type of help as long-term or custodial care. A person living in assisted living can still use Medicare for covered medical care.
What Medicare may cover
Part A may cover an eligible hospital stay, a limited stay in a skilled nursing facility, hospice care, or certain home health services. Part B may cover doctor visits, outpatient care, therapy, durable medical equipment, and other medically necessary services. These benefits do not become assisted living coverage just because the services are provided to a resident.
Medicare may cover eligible home health services delivered at the assisted living residence if the person is homebound, needs part-time or intermittent skilled care, has a provider-certified plan of care, and uses a Medicare-certified home health agency. It does not cover round-the-clock home care, meal delivery, routine housekeeping, or personal care when personal care is the only need.
Costs and other coverage
The resident generally pays all assisted living room, board, and custodial-care charges. The normal deductibles, copayments, and coinsurance apply to separate Medicare-covered services. Medicaid may help some people who meet their state’s financial and functional requirements. Long-term care insurance may also provide benefits, depending on the policy.
Medicare Advantage plans must cover Medicare-covered services. A plan may offer additional benefits, but an extra benefit should not be assumed to pay the facility’s ongoing residential charges. Check the plan’s Evidence of Coverage and confirm whether providers are in network.
What to do next
- Ask the facility for an itemized list of housing, personal-care, and medical charges.
- Ask the medical provider which services will be billed to Medicare.
- Check Medicaid eligibility with the state Medicaid agency if help with long-term care costs may be needed.
- Read the Medicare information on long-term care and home health services.
Sources
Coverage and costs can change each calendar year. Check current Medicare rules and current plan documents before receiving care. A provider’s estimate is not a Medicare coverage decision. Final payment depends on the claim and the applicable coverage requirements.
Last reviewed: August 2026. Medicare rules and plan benefits can change.