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Does Medicare cover the cost of senior housing?

My mother has dementia and has to have help walking. She is in a rehabilation center and my brother and I have power of attorney over her medical. She doesnt want to take her medication and her eating habits are not good. She had a fall and that is why she is in the rehab center. My brother and his family all work so they cant take care of her and I live in california and she doesnt want to come here. My mom is in Illinois and wants to stay there. Can you help me find out if medicare will cover a senior living community.
Status: Open    Jun 17, 2015 - 03:24 PM

Dementia, Medicare/Medicaid

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Jun 24, 2015 - 06:26 AM

Medicare helps pay for medically necessary skilled care. By definition, skilled care must be provided by a licensed professional with medical training, such as a registered nurse. Custodial care/ senior housing is non-skilled care. Medicare doesn't cover it except in select situations when short-term rehabilitative care is required after hospitalization. In this case, the care is part of treating a medical condition, such as re-learning to speak or care for oneself after a stroke. More times than not, Medicaid will cover the cost of senior housing. Medicare is a different story.

Medicare will pay for the cost of this care, including custodial care provided in a skilled nursing facility, for a limited time if:

-You have recent prior hospital stay of atleast 3 days
-You are admitted to a Medicare-certified nursing facility within 30 days of your prior hospital stay
- You need skilled care, such as skilled nursing services, physical therapy or other types of therapy

For older adults, short-term skilled care can transition into the need for long-term non-skilled care. An individual may simply become less able to perform daily tasts as time goes by. It's during this ongoing process that many families start to realize that Medicare is not going to help pay for the ongoing assistance their loved one may need.

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Nov 18, 2015 - 08:28 AM

Short answer- No. Medicaid will cover her long-term care but Medicare will not. She may be eligible for the Widow's pension through the VA if your dad was a wartime vet, and that might provide up to $1,149/mo towards her care, but once she moves out of rehab into LTC, her Medicare will stop paying.

You need to contact an Illinois Elder Law attorney for guidance soon. The nursing home where she currently resides can also help with a Medicaid application, so try them too.

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