If you or your loved ones are getting older, it might be time to consider the next steps in life, like assisted living. Assisted living communities typically provide private apartments and more of a sense of freedom than a skilled nursing facility. We’ll walk you through some need-to-know details regarding assisted living, including its costs and how to pay for them.

It is important to understand that there is a difference between skilled nursing facilities and assisted living; many people think they are the same thing. The difference is that someone in assisted living can do some things independently, while someone in a skilled nursing facility requires more care.

What is Assisted Living?

An assisted living facility is a specialized residential community designed to provide a safe living environment for residents. Most residents are aging adults who need help with aspects of daily living, such as:

  • Housekeeping
  • Bathing and getting dressed
  • Transportation to and from medical appointments

Many assisted living residents have medical needs, though they are not drastic enough for extended, 24-hour care or supervision by licensed medical staff. Assisted living facilities are often intermediary steps between living in your home and a skilled nursing facility (sometimes called a nursing home).

Assisted Living Services

The goal of assisted living is to help our patients still feel they have some independence while keeping them healthy and active. Some services that may be provided in assisted living include:

  • Various levels of care
  • An on-site nursing team that is available 24/7
  • Care support
  • Emergency call service
  • Fall prevention and response
  • Diets specialized to the patient’s needs
  • Cognitive assessments
  • Alzheimer’s and dementia screening and care
  • Post-hospitalization treatments and rehabilitation

Assisted Living Residents

Determining when it’s time to move from your home into an assisted living facility can be challenging. Here are some signs it may be time for you or a loved one to transition to assisted living:

  • Increased fall rates
  • Getting lost when leaving the home
  • Unclean or unsafe home environment
  • Declining personal hygiene, like wearing the same clothes for multiple days
  • Difficulty performing daily living tasks like preparing meals or bathing

If you’ve noticed these signs in a loved one, it may be time to consider assisted living.

How Much Does Assisted Living Cost?

The costs of assisted living are broken down into a few different categories.1  

Move-In Costs

A lot of assisted living communities charge move-in fees. These fees can be paid upfront, or they can be prorated. The fees depend on the community, but the average cost is between $1,000 and $5,000.

Residential Costs

Case managers will work with families if their social security benefits don’t fully cover assisted living costs. If you need help working out the finances, a case manager is here to help find programs available and other resources to help cover the costs associated with assisted living.

Residential costs for assisted living communities vary from community to community. The prices typically depend on:

  • The size of your apartment
  • Your geographical location
  • The number of services you need

In 2021, the national median cost for assisted living communities was $4,500 monthly. This amount equals about $148 per day and $54,000 per year. The same survey discovered that nursing homes cost over $9,000 a month. Home health aide services cost, on average, more than $56,000 a year.

If cost is a concern, assisted living seems to be the most cost-effective overall.

Medical Costs

Those living in assisted living communities still have medical needs that require coverage. These medical costs include routine doctor visits, appointments with medical specialists, required therapies, and medication.

Thankfully, whether through a private insurer or a government program like Medicare, health insurance covers their portion of medical costs even while the subscriber resides in an assisted living facility.

Paying for Assisted Living — Does Health Insurance or Medicare Pay for Assisted Living?

Many older folks have Medicare, but does Medicare pay for assisted living?

Unfortunately, Medicare usually doesn’t pay anything toward rent in assisted living facilities. Most residents have to pay out-of-pocket for assisted living monthly rental costs, although some can find coverage through long-term insurance and other avenues. There are affordable assisted living facility options with Encore Communities at Clearbook Inn and Laurel Cove Community.

Medicare Coverage for Senior Living

Medicare sometimes pays for skilled nursing care if their coverage criteria are met. Skilled nursing facilities provide higher care than assisted living facilities, so you or your loved one may not need skilled nursing care. If that is the case, Medicare will not cover skilled nursing care.

Medicaid

Medicaid is a federally funded program that helps low-income individuals, individuals with disabilities, or chronic health conditions afford some aspects of assisted living.

Some of the services Medicaid will pay for include:

  • Personal care assistance, such as eating, bathing, and dressing
  • Homemaking assistance, such as laundry and house cleaning services
  • Transportation services
  • Case management

While Medicaid doesn’t pay for room and board, it can help offset residential costs by paying for essential services.

Social Security Benefits

Residents can also use their Social Security benefits to pay for some of the assisted living costs. Starting at age 62, you can start to receive your Social Security benefits. If your social security benefits don’t completely cover the cost of assisted living, a case manager may be able to help with other funding options.

Not All Assisted Living Communities Are the Same

Assisted living communities are typically privately owned residential communities, which means that aside from healthcare or residential regulations, they can operate in their own ways.

This means that not every assisted living community accepts payments the same way. Before examining your budget to figure out ways to pay for assisted living, you should contact the community directly. Most assisted living centers will have a case manager to help you decide and transition to assisted living.

If you have an assisted living community in mind that you’re interested in living in or moving your loved one into, contact the community to learn more about what resources are available to you.

Assisted Living at Encore Communities

Encore Communities has two assisted living communities that specialize in helping residents maintain as independent of a life as possible. You can learn more about Encore Communities by calling today to speak with a team member.

 

Sources:

[1] https://www.whereyoulivematters.org/how-much-does-assisted-living-cost/

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