Does Medicare Pay for Assisted Living?

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The answer is no, Medicare does not cover assisted living in Canada but there are other alternatives available to Canadians.

Medicare is a popular term used to refer to Canada’s publicly funded healthcare system. It covers a range of medical services of which assisted living may or may not be a part. As a senior resident in Canada, you may be needing alternative housing options, and assisted living is one of them.

Are you having conflicting thoughts on whether or not Medicare covers assisted living in Canada? Let’s find out if Medicare will cover assisted living costs if you decide to choose it.

Medicare in Canada

Medicare is broken down into provincial and territorial healthcare insurance plans in place of one national healthcare plan. Through Medicare, residents of Canada have access to necessary medical services free of charge.

The Canadian government is responsible for providing funding for healthcare to all provinces and territories through the Canada Health Transfer. Medicare primarily caters to medical services each province or territory deems critical.

Medicare does not fund additional healthcare services; the provincial government takes care of this service. However, neither Medicare nor the free additional healthcare services provided by the provinces and territories pay for assisted living.

The reason being that the federal and provincial governments do not consider assisted living and other forms of nursing care as emergency medical services. Hence, consumers would have to pay out-of-pocket.

Assisted Living in Canada

Assisted living is a housing alternative for senior residents in Canada who cannot live independently without support. This living arrangement helps seniors with their day-to-day activities like:

  • Shopping and preparation of meals
  • Cleaning
  • Personal care
  • Taking prescribed medication
  • Booking doctor’s appointment

Assisted living in Canada is structured in a way that the seniors live in apartments close to one another. Hence why people referred to them as assisted living communities. Also, the range of services varies between communities. 

Note that assisted living is for senior citizens who need support to live but not intensive nursing care. Therefore, the medical service that is rendered in assisted living communities is limited. 

Also, there is medical personnel available to monitor and check on the residents. The personnel does not make a diagnosis but regularly check in to ensure that residents are in good health. However, a lot of assisted living communities offer transition options to nursing care if a need arises.

How to Pay for Assisted Living in Canada

Since Medicare does not cover assisted living, you can pay for assisted living in Canada via the following means:

  • Health insurance/ Long-care plan
  • Employment Benefit programs
  • Medicaid
  • Canada Pension Plan Benefit
  • Old age security (for senior residents of age 65 and above)
  • Tax Credits
  • Personal savings and investments
  • Family and Friends 
  • Rental and sales of assets

For coverage of assisted living by insurance or care plans, you may need to get your doctor’s prescription or other medical orders showing that you need assisted living. Averagely, assisted living in Canada costs between CA$1500 to CA$6000 depending on services.

Alternative to Assisted Living in Canada

Besides assisted living, there are other affordable housing options for senior residents, one of which is independent living. It is a housing option for people who can support themselves but don’t want to be alone.

Provinces and territories cover it as a supplemental healthcare service. Also, each province and territory has housing options for senior residents and citizens alongside funding options too. 

Conclusion

Medicare doesn’t pay for assisted living but rather for necessary medical services. As an alternative, you can seek other payment options to offset your Assisted living bills. Also, you can check out other housing options for affordable seniors residents similar to assisted living in Canada.

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Kareena Maya is a freelance writer focused on the personal finance and travel spaces. He frequently writes about credit cards, banking, student loans, insurance, travel rewards and more. His work has been featured in publications such as Forbes Advisor, Bankrate, Credit Karma, Finance Buzz, The Ascent and Student Loan Planner.

Kareena Maya is a freelance writer focused on the personal finance and travel spaces. He frequently writes about credit cards, banking, student loans, insurance, travel rewards and more. His work has been featured in publications such as Forbes Advisor, Bankrate, Credit Karma, Finance Buzz, The Ascent and Student Loan Planner.