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Medicare and Medicaid

When you’re searching for an assisted living facility, nursing home or other senior care services, it’s important to understand what Medicare and Medicaid will cover. In general, staying in a long term senior community such as an assisted living community or retirement community isn’t covered by either Medicare or Medicaid. These long term senior communities are private pay facilities that offer services and amenities tailored to long term senior residents.

Medicare Coverage

Federally funded by the US government, Medicare is a program for assisting US citizens age 65 and over. There are four types of Medicare Coverage setup in Groups A – D.

Understanding Medicare Coverage

Medicare covers care of seniors age 65 and over for a short term stay in a nursing home that’s a skilled nursing care facility. Medicare coverage will pay for all or a majority of care costs at a hospital, short term rehabilitation center, in-home, nursing home or hospice. To understand what Medicare Coverage Type your loved one has and services that are covered, contact your Medicare Fiscal Intermediary or your local State Health Insurance Assistance Program.

Medicaid Coverage

Medicaid programs are funded individually by States for low-income seniors. Based on eligibility for receiving Medicaid coverage, Federal law requires that each State provides a specific range of senior care services to Medicaid Patients. Each State varies on the services offered and covered by their Medicaid program. For specific details contact your local State Medicaid office. Medicaid programs in most states will cover stays with limitations on length of the stay for hospitals, nursing homes and skilled nursing facilities. Extra length in stays would have to be covered by private pay.