[Last updated September 24, 2024]

A senior woman wears professional clothing and looks out a window, smiling, as she holds a folder.

As the population ages, many may wonder what help they can receive to cover the cost of senior care. Although there are many options for paying for senior care, it is important to know which ones are viable and available to you. Medicare Advantage may be able to help cover the costs of many expenses, including some senior care services. Here is everything you need to know about Medicare Advantage and senior care.

What are Medicare and Medicare Advantage?

Medicare is a federally provided program that offers health insurance for:

  • Adults over 65.
  • People under 65 with disabilities.
  • Those with end-stage renal disease or Lou Gehrig’s disease (ALS).

Note that though the names sound similar, Medicare is not the same as Medicaid, which offers health insurance to people with low income and assets.

There are four parts to Medicare:

As mentioned above, Medicare Advantage — also referred to as Medicare Part C — is a Medicare alternative offered through private insurance companies. Medicare approves these companies, which must provide the same coverage offered by Medicare Parts A and B (also referred to as original Medicare). Medicare Advantage plans typically include additional coverage not offered by original Medicare. Common additional coverage includes:

  • Prescription drugs.
  • Vision.
  • Dental.
  • Home health services.
  • Over-the-counter drug allowance.
  • Gym memberships.
  • Telehealth services.

The coverage and cost of each plan vary based on the insurance provider and the individual’s location.

What is senior care?

Senior care — also called eldercare — is a plethora of services that assist seniors in their later years. These services can be provided at home, assisted living centers, nursing homes, doctor’s offices, and more. Several types of eldercare exist, from transportation to and from medical appointments to assisting seniors who require round-the-clock care such as bathing, feeding, and emergency services.

Below are more examples of senior care services:

  • Independent living: Residential communities for older adults who live independently and can take care of themselves.
  • Assisted living: Residential communities for seniors who are relatively independent but need some assistance with daily tasks.
  • Nursing homes (also called skilled nursing facilities): Residential facilities offering medical and rehabilitation services as well as extensive daily care.
  • Memory care: Specialty care for seniors with cognitive decline and memory issues.
  • Respite care: Short-term senior care to temporarily relieve family members of their caregiving duties.
  • Home care: Nonmedical personal assistance provided in the home.
  • Home health care: Skilled medical services, such as wound care or physical therapy, provided in the home.

Do Medicare Advantage plans cover senior care?

Medicare and Medicare Advantage may cover some senior care costs. However, since these plans are medical insurance, they typically do not cover senior care costs associated with personal or custodial care, such as assistance with activities of daily living (personal tasks like bathing, eating, toileting, etc.). Skilled nursing facility stays may be covered, but only temporarily and only if the care needed is medically necessary. Individuals must meet other requirements to receive coverage for skilled nursing facility stays. Those in need of long-term or permanent nursing home care or care for custodial needs, however, will need to seek other funding.

Medicare and Medicare Advantage do not cover assisted living, as the assistance provided there is not medical in nature. These plans may cover some additional skilled services for a limited time that a resident might receive while living there, such as physical therapy, but they do not cover room and board or the personal assistance provided at assisted living.

Medicare and Medicare Advantage may cover some home health care services for seniors for a limited amount of time. This can provide significant relief for caregivers, family members, and friends by helping offset the costs of senior care at home. Original Medicare typically does not cover nonmedical home care services, such as assistance with activities of daily living, except in some cases in which the individual is homebound and a doctor certifies that the care is medically necessary. Some Medicare Advantage plans, however, may cover nonmedical home care.

Although Medicare Advantage offers limited coverage of senior care, some plans may offer extra coverage that can assist with caregiving needs, which can include the following:

  • Adult day care.
  • Caregiving support.
  • Transportation to medical appointments.
  • Limited at-home meals.

Note that thousands of Medicare Advantage plans are available across the country, and the benefits can vary significantly from plan to plan. Be sure to check with your insurance provider to see if their plan can cover your needs.

Alternative options to pay for senior care

Since Medicare Advantage plans do not cover all the necessary senior expenses, knowing additional options to pay for senior care is imperative. Here are several of the most common options:

  • Private pay, such as retirement savings or proceeds from a home sale.
  • Long-term care insurance.
  • Long-term care annuity.
  • Hybrid life insurance and long-term care insurance policy.
  • Short-term care insurance.
  • Selling your existing life insurance policy.
  • Veterans benefits.
  • Bridge loans.
  • Medicaid and Medicaid waivers.
  • The Program of All-Inclusive Care for the Elderly (PACE).

Final thoughts on Medicare Advantage and senior care

Although Medicare Advantage plans have many perks, senior care services may not be covered. As senior care and assisted living centers can be quite costly, knowing whether your Medicare Advantage plan covers any of the costs is essential to properly plan for a senior’s care. If you have or are interested in a Medicare Advantage plan and foresee the need for senior care, check with the insurance provider to verify which services are covered and if there are any criteria to qualify for coverage. The right plan can ensure that you or your older adult loved one can get assistance in paying for the care they need to remain safe and healthy.