Follow
Share

Prior to her Alzheimer's diagnosis, my mother and I agreed it was time to move her to a senior community. I believe in some situations, if a senior community is recommended by a doctor, it can be covered by health insurance. Is this true? And would my mother still be eligible even though we were being proactive by moving her to a senior community before the diagnosis?

Find Care & Housing
Lbarnett, you should go to Medicare directly, they can guide you to what is covered and what is not.

The only time I am aware that Medicare covers room and board is in hospital and a rehabilitation facility, those have limited days of coverage before you go to self pay.

I have never read anything that even indicates they will pay for someone's apartment or room, it's HEALTH insurance.
Helpful Answer (4)
Reply to Isthisrealyreal
Report

This senior living should include 24/7 memory care to stop her wandering. Unfortunately, this is a memory loss type of long-term care, not a medical condition, so it's not covered by Medicare. Obtain a full evaluation & assessment from your mother's doctor and social worker of the county where she lives.
Helpful Answer (0)
Reply to Patathome01
Report

If she has a long-term care policy, check with the insurance company to learn what her coverage is, if any.
Helpful Answer (5)
Reply to Fawnby
Report

Medical insurance does not cover custodial care, it only covers medical care. Custodial is not medical.

A doctor doesn't "prescribe" Assisted Living or Memory Care. They can assess someone for requiring Long Term Care in a facility. This is a criteria when applying for Medicaid. Then one's SS income covers the custodial care. For Medicaid, a person has to qualify both medically and financially. It varies by state.
Helpful Answer (3)
Reply to Geaton777
Report
LBarnett Apr 27, 2025
Are you saying that her ssa could cover custodial? What costs fall under custodial?
(0)
Report
See 1 more reply
No, senior living as in memory care or ALF is not covered by medical insurance, so I am uncertain of your meaning. Medical insurance covers medical needs for medications, MD visits, hospitalizations and etc. Senior living, such as Assisted Living, provides both a rental base cost, and then care costs according the the levels of care required, usually I through IV or V.

And of course diagnosis is a requirement for entry into any facility. There will be exams to ascertain health, abilities, safety issues, general mental and physical health and requirements, and etc. You make some statements about "prior to her Alzheimer's diagnosis" and then "we are being proactive by moving her prior to diagnosis". This is confusing. Has she, or has she not been diagnosed as having Alzheimer's. In order to be safe in ALF rather than Memory Care she would require a thorough workup.
It isn't fair either to her or to other residents in care to have unsafe placement.

Wishing you good luck.
Helpful Answer (3)
Reply to AlvaDeer
Report
LBarnett Apr 27, 2025
We moved her to a senior community as an independent with no assistance needed. This senior community offers independent living, assisted and memory care.
(1)
Report
Ask a Question
Subscribe to
Our Newsletter