Does Medicare Pay for Assisted Living? What California Families Should Know

Quick answer: No. Medicare doesn’t pay for room and board or daily help with things like bathing and dressing in assisted living or a board and care home. It still pays for doctor visits, hospital care and, with a drug plan, prescriptions. Open Enrollment runs October 15 to December 7, a good time to check that your parent’s plan still fits.

You may have just found out that Mom can’t safely live alone anymore. Then you hear the price of a care home and think, “Medicare will cover some of this, right?”

It’s one of the most common questions families ask us. The honest answer is hard to hear, but knowing it early saves you weeks of chasing the wrong lead. Here’s what Medicare does, what it doesn’t, and what to look at during Open Enrollment if your parent lives in a care home or may move soon. It’s general information, not medical, legal or financial advice.

The short version

• Medicare doesn’t pay for long-term care, like rent and daily help in assisted living or board and care.
• Medicare still covers your parent’s medical care while they live there.
• Short rehab in a skilled nursing facility is different, and it has limits.
• Open Enrollment is October 15 to December 7. Changes start January 1.
• HICAP gives free Medicare counseling in California: 1-800-434-0222.

What does Medicare pay for in a care home, and what doesn’t it?

Medicare is health insurance. It pays for medical care. Most of what an assisted living or board and care home does is help with daily life, like meals, bathing, dressing, reminders and someone awake at night. Medicare calls that “long-term care” or “custodial care,” and it doesn’t pay for it (Medicare.gov). Medigap plans don’t either.

Here’s how it usually breaks down:

• Monthly rent (room and board). Does Medicare pay? No.
• Daily help with bathing, dressing, meals, toileting. Does Medicare pay? No.
• Doctor visits and lab work. Does Medicare pay? Yes, as usual under their plan.
• Hospital stays. Does Medicare pay? Yes, as usual under their plan.
• Prescriptions. Does Medicare pay? Yes, with a Part D plan or a Medicare Advantage plan with drug coverage.
• Short rehab in a skilled nursing facility. Does Medicare pay? Sometimes, for a limited time (see below).
• Hospice care in the care home. Does Medicare pay? Hospice services, yes. Room and board, no.

The surprise: Medicare pays nothing toward the monthly bill at an assisted living or board and care home. Not part of it, and not after a waiting period. The rent and daily care are paid some other way.

Is short-term rehab the same as long-term care?

No, and this is where a lot of the confusion starts.

After a hospital stay, Medicare Part A can cover care in a skilled nursing facility for a while. Your parent needs a qualifying inpatient hospital stay of at least 3 days in a row first. Time spent “under observation” or in the ER doesn’t count, even overnight. Their doctor must also say they need daily skilled care, like therapy (Medicare.gov).

In 2026, here’s what that looks like with Original Medicare:

• Days 1 to 20: $0 a day, after the Part A deductible
• Days 21 to 100: $217 a day
• Day 101 and after: your parent pays all costs

Medicare Advantage plans can have different copays, so check with the plan.

Rehab is meant to help someone get stronger. It isn’t a place to live long term. When rehab ends, many families have to decide fast where Mom goes next. If that’s you, read Leaving the Hospital in 48 Hours: A Family Checklist.

Does Medicare pay for hospice in assisted living?

Hospice is comfort care for someone whose doctor says they have about 6 months or less to live. Medicare Part A covers hospice care, and your parent can usually get it in the place they live, including an assisted living home. But Medicare doesn’t pay room and board for someone who lives in a facility and chooses hospice (Medicare.gov). The care home’s monthly bill keeps coming.

If you’re thinking about hospice, talk with your parent’s doctor and the hospice team. They can explain what’s covered for your parent.

Open Enrollment: what are the dates, and what should you review?

Medicare Open Enrollment runs October 15 to December 7 each year. During this time, your parent can switch Medicare Advantage plans, move between Original Medicare and Medicare Advantage, or join, switch or drop a drug plan. Changes start January 1, and the plan must get the request by December 7 (Medicare.gov).

If your parent is already in a Medicare Advantage plan, there’s a second window from January 1 to March 31 to switch plans or go back to Original Medicare.

We can’t tell you which plan to pick, and you shouldn’t take plan advice from a placement service. But we can tell you what families with a parent in care (or about to move) often forget to check:

• Are their doctors still in the plan’s network next year?
• If they’re moving, are there in-network doctors near the new home?
• Which pharmacy does the care home work with, and is it in the plan’s network?
• Are all their medications still covered next year, and at what cost?
• Did the plan send a notice about changes for next year? Read it.
• Does the plan cover care in other areas if your parent moves across the state?
• Who in the family is allowed to talk to the plan for your parent?

Medicare.gov says to ask doctors and pharmacies whether they’re in the plan’s network, and to review premiums, deductibles and drug costs before joining a plan.

Moving outside Open Enrollment? A move to a new address can open a Special Enrollment Period, so your parent may be able to change plans after a move even if Open Enrollment is over. Ask HICAP or 1-800-MEDICARE (1-800-633-4227) what applies.

Where can you get free Medicare help in California?

HICAP (Health Insurance Counseling and Advocacy Program) is California’s free Medicare counseling program. Trained counselors give free, confidential, one-on-one help with Medicare, Medi-Cal questions and long-term care insurance. They don’t sell plans. Call 1-800-434-0222 to reach the HICAP office for your county (California Department of Aging).

HICAP is a smart first call during Open Enrollment, especially if your parent’s needs or address are about to change.

If Medicare doesn’t pay, what does?

Most families use a mix. Here are the usual pieces:

• Your parent’s own money. Income like Social Security or a pension, plus savings. See Does Social Security Pay for Assisted Living?
• Long-term care insurance, if your parent bought a policy. Call the insurer to ask what it covers and how to start a claim.
• VA benefits for some veterans and surviving spouses. See our VA Aid and Attendance guide.
• Medi-Cal’s Assisted Living Waiver in some counties, including Sacramento. It’s not offered in Placer County, and there’s a waitlist (DHCS). See our Medi-Cal waiver guide.

Our family roadmap for paying for senior care walks through each one step by step.

What should you do next?

• If your parent is in the hospital now, then ask whether they’re admitted or under observation, and read our hospital discharge guide.
• If your parent just moved into a care home, then check their plan’s network for doctors and the home’s pharmacy before December 7.
• If you’re not sure which plan questions to ask, then call HICAP at 1-800-434-0222.
• If you need to figure out what care will cost, then read our assisted living cost guide and call or text us.

Local facts for Sacramento and Placer families

• Cost: Most licensed care homes in our area cost $4,000 to $15,000 a month, depending on the home and the care. A few homes charge less, but a price under $4,000 a month is rare. CareScout’s 2025 median for assisted living in California is $7,000 a month.
• Board and care, shared room: often about $5,000 to $7,000 a month.
• Medi-Cal waiver: offered in Sacramento County, not Placer County.
• Agency on Aging Area 4 gives free information to seniors and families in Sacramento and Placer counties: (916) 486-1876 or (800) 211-4545 (Agency on Aging Area 4).

How Nonna Placements works: Nonna Placements is free to families. Licensed homes pay us a placement fee when someone moves in. You can choose any home. If the first home doesn’t work out, we find another one for free. We don’t sell insurance or Medicare plans. This article is general information, not medical, legal or financial advice.

Not sure how you’ll pay? Talk it through with us

Finding out Medicare won’t help is a hard moment. You don’t have to sort out the rest alone. We can talk through care needs, budget and the kinds of homes that may fit. If staying home makes more sense, call or text us and we can help you find in-home care options.

Nonna Placements helps families across California, with a focus on Placer and Sacramento counties. We only suggest homes we’ve seen ourselves, and we can come on tours with you. For out-of-state families, we offer video tours. It’s free to your family. If your parent is leaving the hospital soon, tell us when you call so we can move quickly.

Call or text (916) 261-2644 or email roberto@nonnaplacements.com. We reply within 1 hour, 24/7.

Related reading: How Will We Pay for Mom’s Care? A Sacramento and Placer Family Roadmap · How Much Does Assisted Living Cost in Sacramento in 2026? · How Nonna Placements Gets Paid · Senior living in Sacramento

Sources

• Medicare.gov, Long-term care (checked October 28, 2026): medicare.gov
• Medicare.gov, Skilled nursing facility care, 2026 costs (checked October 28, 2026): medicare.gov
• Medicare.gov, Hospice care (checked October 28, 2026): medicare.gov
• Medicare.gov, Joining a plan (enrollment periods) (checked October 28, 2026): medicare.gov
• California Department of Aging, HICAP Medicare counseling, 1-800-434-0222 (checked October 28, 2026): aging.ca.gov
• California Department of Health Care Services, Assisted Living Waiver (checked October 28, 2026): dhcs.ca.gov
• CareScout Cost of Care Survey, 2025 California assisted living median: carescout.com
• Agency on Aging Area 4 (checked October 28, 2026): agencyonaging4.org

About the author

Roberto Hategan is the CEO & Founder of Nonna Placements, a senior placement service in Granite Bay serving families across California, with a focus on Placer and Sacramento counties. We only suggest homes we’ve seen ourselves. Contact: roberto@nonnaplacements.com

Photo credits: Leeloo The First, Polina Tankilevitch and Leeloo The First, via Pexels, Pexels License.