Tulsa Senior AdvisorDoes Medicare pay for assisted living in Oklahoma?
No. Medicare does not pay rent, meals or personal care in assisted living, in Oklahoma or anywhere else; it may still cover doctor visits, therapy, home health or hospice delivered to a resident there.
Assisted living is paid privately, through long-term care insurance, VA pension with Aid and Attendance, or SoonerCare's ADvantage waiver for services (not room and board).
How long does Medicare pay for a nursing home stay?
Medicare Part A covers up to 100 days of skilled nursing facility care per benefit period after a qualifying inpatient hospital stay of at least three days, with the first 20 days fully covered and a daily coinsurance after that, and only while skilled care is needed.
Time spent in the hospital under observation status does not count toward the three days, so ask the hospital whether your parent is formally admitted. When skilled care ends, Medicare coverage ends, even if day 100 has not arrived.
Does Medicare pay for home care?
Medicare pays for intermittent skilled home health, such as nursing visits and therapy, for a homebound patient under a doctor's plan, but not for hourly or round-the-clock personal care or homemaker help.
OSDH runs a home health (Medicare) hotline at (800) 234-7258 for complaints about home health agencies.
Where can Tulsa families get free Medicare counseling?
Oklahoma's State Health Insurance Assistance Program is the Medicare Assistance Program (MAP) at the Oklahoma Insurance Department, 1-800-763-2828, which gives free, unbiased Medicare counseling.
MAP counselors can compare Medicare Advantage and supplement plans and check whether a plan includes the nursing homes and home health agencies you are considering.
Does Medicare cover hospice in assisted living or a nursing home?
Yes. Medicare's hospice benefit covers the hospice team, medications for the terminal illness, equipment and supplies wherever the patient lives, including an assisted living center or a nursing home, but it does not pay room and board in either.
That makes hospice one of the few Medicare benefits that adds real help inside assisted living. Ask any center whether it works with the hospice you prefer.
At a glance
| Medicare pays for | Medicare does not pay for | |
|---|---|---|
| Nursing home | Short skilled stays after a qualifying admission | Long-term custodial stays |
| At home | Intermittent skilled home health | Hourly personal care |
| Assisted living | Medical services delivered there | Rent, meals and personal care |
Sources include the Oklahoma Administrative Code (chapters 310:663, 310:680, 310:673, 310:675 and 310:605), OSDH, the Oklahoma Health Care Authority, Oklahoma Human Services, the Oklahoma Attorney General, CareScout, CMS and the VA, as cited above; see our editorial standards.
