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What Medicare Does and Does Not Pay For

Medicare covers short skilled nursing stays, home health and hospice. It does not pay for assisted living or custodial care, in any state.

HomeCosts & PayingWhat Medicare Does and Does Not Pay For
Short answer

Medicare does not pay for assisted living, memory care, or long-term custodial care anywhere in the country. It covers limited skilled nursing facility stays after a qualifying hospital admission, intermittent skilled home health, and hospice.

What Medicare covers

  • Skilled nursing facility care after a qualifying inpatient hospital stay, for a limited period, when skilled care is needed daily. This is rehabilitation, not long-term placement.
  • Home health that is intermittent and skilled — nursing visits, physical, occupational or speech therapy. Not a caregiver who stays with your parent.
  • Hospice — the hospice team, medications related to the terminal diagnosis, and equipment. Not room and board in a facility.
The observation status trap. A Medicare skilled nursing benefit requires a qualifying inpatient hospital admission. Time spent under “observation status” does not count, even if your parent slept two nights in a hospital bed. Ask the hospital directly whether your parent is admitted as an inpatient or under observation, and ask in writing.
What senior care costs. TODO: your state's real assisted living and nursing home cost medians, once sourced. Read the full explanation →

Questions families ask

My parent was just diagnosed with dementia — what should our family actually do first?

Start by asking the diagnosing physician for a written care-needs assessment, and separately confirm whether any assisted living community you're considering holds SNALR certification if secured memory care is part of the plan.

How do I manage care for a parent in Buffalo when I live in another state?

Set up a local point of contact early — this can be a paid geriatric care manager, a trusted family friend, or in some cases the facility's own social worker — and get durable power of attorney and health care proxy documents in place before a crisis, not during one.

How do I choose between two assisted living communities in the Buffalo area that seem similar?

Ask to see each community's current state inspection record, request the all-in monthly cost at your parent's specific care level (not the advertised starting rate), and ask about overnight staffing ratios specifically — not just daytime.

What happens if my parent's needs eventually exceed what their current community's license allows?

Ask this question before move-in, not after: specifically, what level of decline would require a transfer, and where does the community typically transfer residents when that happens.

What's the difference between Erie County and Niagara County for senior care planning?

Erie County is the metro's urban/suburban core, anchored by Buffalo and its inner-ring suburbs, with the widest concentration of licensed communities. Niagara County is more rural/agricultural overall, anchored by Niagara Falls and Lockport (the county seat).

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