Albany Senior AdvisorDoes Medicare pay for assisted living near Albany?
No: Medicare does not pay rent or personal care in any assisted living residence, though it still covers doctor visits, therapy, hospice and medical equipment for a beneficiary who lives in one.
Families are often told otherwise, sometimes by well-meaning friends. If a residence suggests Medicare will pay its monthly fee, ask to see that in writing.
When does Medicare cover a skilled nursing stay after Albany Med or St. Peter's?
Original Medicare covers skilled nursing facility care only after a qualifying inpatient hospital stay of at least three midnights, for up to 100 days per benefit period, and only while the patient needs and benefits from daily skilled care.
Days 21 through 100 carry a daily coinsurance. Observation days do not count toward the three midnights, so ask the hospital whether your parent is formally admitted. Medicare Advantage plans may waive the three-day rule but use their own authorization process.
Does Medicare pay for home care in the Capital Region?
Medicare pays for intermittent skilled home health care, such as nursing visits and physical therapy, for homebound patients under a doctor's plan, delivered by a Medicare-certified home health agency; it does not pay for ongoing hourly aides or companions.
Agencies with Capital Region office addresses on the state roster include 5 certified home health agencies, 60 licensed home care services agencies and 2 hospice licenses; many serve several counties, so ask each one whether it covers your parent's town.
Does Medicare cover hospice care?
Yes: Medicare's hospice benefit covers the hospice team, medications and equipment related to the terminal illness, and short inpatient or respite stays, for patients whose doctor certifies a life expectancy of six months or less, wherever they live.
New York's roster shows 2 hospice licenses with offices in the nine counties: High Peaks Hospice and Palliative Care, Inc., The Community Hospice, Inc.. Hospice does not cover room and board in a nursing home or assisted living residence.
Where can Albany-area seniors get free Medicare counseling?
The Health Insurance Information, Counseling and Assistance Program (HIICAP), offered through the county Offices for the Aging, gives free, unbiased counseling on Medicare, Medicare Advantage, Medigap and drug plans.
Call the county Office for the Aging, for example the Albany County Department for Aging at (518) 447-7198 or Saratoga County at (518) 884-4100, and ask for a HIICAP appointment, ideally before open enrollment each fall.
Side by side
| Medicare covers | Medicare does not cover | |
|---|---|---|
| Rehab | Up to 100 days of skilled nursing after a qualifying stay | Long-term nursing home care |
| Home | Intermittent skilled home health | Hourly aides and companions |
| Assisted living | Medical services for residents | Rent or personal care |
| Hospice | The team, drugs and equipment | Room and board |
Where this page states a rule or a dollar figure, it relies on New York statute or regulation (Social Services Law, Public Health Law, 18 NYCRR and 10 NYCRR), Department of Health GIS messages and directories, CMS, the VA or CareScout, as named in the text. How we source facts: editorial standards.
