Will Medicare or Health Insurance Cover My Assisted Living Projects?

As our bodies change with age, so too do our homes. While some elderly individuals might require or prefer to move into assisted living facilities, a vast number of Americans continue to live independently and modify their homes to be more accessible. The scope and cost of any home improvement project can be a stressor, and especially so when we are older and potentially living on tighter budgets. But will government programs like Medicare or private insurance cover the cost of these assisted living projects?

Common Assisted Living Projects

Before a homeowner can budget for what costs will be covered versus what they will be responsible for, it is important to understand the types of modifications that are available as assisted living projects.

These can include:

• Accessible fixtures, such as oversized light switches or faucet levers
• Pull-out shelving in bathrooms, kitchens, or closets
• Home security systems, including medical alert systems
• Stair lifts
• Widened doorways for wheelchairs or walkers
• Non-skid flooring or strips in bathrooms
• Seated or walk-in tubs
• Grab bars or railing
• Ramps
• Elevated toilet seats
• And more

Medicare Coverage

Many people assume that Medicare will provide them with some, if not all the assistance they will need as they age. While the program is a primary source of medical insurance for seniors that helps offset the costs of inpatient care and certain doctors’ services, unfortunately it typically does not cover long-term, outpatient care or home modifications associated with assisted living. 

There are some exceptions to this general rule. Medicare may pay for assistive technology devices that are required for medical reasons. It may be possible to receive assistance in paying for a home evaluation by an occupational therapist to determine required changes.

For seniors with a Medicare Advantage (MA) plan, or Medicare Part C, offered through private insurance companies, there might be the option to purchase supplemental health benefits. These benefits can include coverage for medical-related home modifications, and sometimes even non-medical benefits for chronically ill persons in certain scenarios. 

MA plans vary by state and provider. Therefore, seniors should discuss with their insurance company the options available in their network and what, if any, assisted living project costs can be covered by the plans.

Other Ways to Pay for Assisted Living Projects

Beyond a Medicare Advantage plan, senior homeowners have several options to offset the costs associated with assisted living projects.

Several of these options vary by state and eligibility. Nonetheless, they can help reduce out-of-pocket and certainly worth exploring as finance options.

Medicaid HCBS Waivers

Most states have Home and Community Based Services (HCBS) Waivers through Medicaid—a federal and state insurance program that offers assistance to low income seniors. These waivers can help qualified seniors maintain their independent living, and therefore, in some areas, pay for assisted living home projects.

Non-Medicaid Government Assistance

The Department of Housing and Urban Development provides several programs for home improvement loans and grants, while the U.S. Department of Agriculture offers loans and grants for housing repair. Many states also have nursing home diversion programs, intended to prevent or delay nursing home placement, including through home modification assistance.

Veterans Programs

There are home modification assistance programs available to veterans from both the Department of Veterans Affairs and non-profit organizations for veteran seniors.

Non-profit Assistance

Seniors do not need to have a military background for assistance from non-profit organizations. There are countless groups across the country that offer financial assistance or volunteer labor to help aging homeowners with their assisted living projects.

Research non-profits in your area or connect with a local non-profit center, if available, to learn more about the groups in your area willing to help. There are also multiple national groups that can help with specific projects, such as wheelchair ramp installation.

Insurance Policies 

Certain insurance policies might cover the costs associated with home modifications, or offer supplemental coverage to do so in the future. Check with your insurance provider to find out if these options are available in your area.

Home Loans

While loans might not be the most feasible option for every senior, there are numerous financial institutions or governmental organizations that offer low-interest loans to seniors in need of home modifications. Opting for a loan should only be decided on after speaking with a personal financial expert.

Deduct the Costs

Luckily, there are some home improvements that are tax-deductible. Improvements to your home can be deducted on your tax filings as medical expenses if they are medically necessary. These projects can include many of those listed above. Speak with a tax professional or Certified Public Account (CPA) to determine what costs can be deducted when you file and how much.

Next Steps for Your Assisted Living Project

Learn more about the top 2021 home improvement projects that seniors should invest in. We also recommend exploring COVID-19’s impact on home accessibility projects before getting started.

Requiring home modifications as you age is a common stage of life. While navigating the costs of assisted living projects can be a headache, it does not have to be. The pros at Modernize can help connect you with trusted contractors in your area who can make the accessible modifications you need to continue living an independent life.