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What Medicare Does and Does Not Pay For

Medicare covers short skilled nursing stays, home health and hospice. It does not pay for assisted living or custodial care, in any state.

HomeCosts & PayingWhat Medicare Does and Does Not Pay For
Short answer

Medicare does not pay for assisted living, memory care, or long-term custodial care anywhere in the country. It covers limited skilled nursing facility stays after a qualifying hospital admission, intermittent skilled home health, and hospice.

What Medicare covers

  • Skilled nursing facility care after a qualifying inpatient hospital stay, for a limited period, when skilled care is needed daily. This is rehabilitation, not long-term placement.
  • Home health that is intermittent and skilled — nursing visits, physical, occupational or speech therapy. Not a caregiver who stays with your parent.
  • Hospice — the hospice team, medications related to the terminal diagnosis, and equipment. Not room and board in a facility.
The observation status trap. A Medicare skilled nursing benefit requires a qualifying inpatient hospital admission. Time spent under “observation status” does not count, even if your parent slept two nights in a hospital bed. Ask the hospital directly whether your parent is admitted as an inpatient or under observation, and ask in writing.
What senior care costs. New York's CareScout median is $7,110/month for assisted living and $16,729/month for a private nursing home room. Read the full explanation →

Questions families ask

Is there a Long Island-specific senior care cost figure, or only a statewide number?

Only a statewide figure is published. CareScout confirms that its publicly downloadable National and State Data Tables report, the source for the cost figures cited throughout this site, provides state-level and national medians only. CareScout's underlying survey does collect metro-area (MSA-level) data that feeds its separate interactive online cost calculator, but that breakout is not included in the downloadable state tables.

Who is the Long-Term Care Ombudsman for Suffolk County, and what do they do?

Suffolk County's regional Long-Term Care Ombudsman Coordinator is Elizabeth Maxim, sponsored by Family Service League (FSL), 1444 Fifth Ave., Bay Shore, NY 11706, phone 631-470-6755. The Ombudsman Program advocates for residents in Suffolk County skilled nursing homes, assisted living, adult homes, and family-type homes for adults, and operates as part of the statewide Long Term Care Ombudsman Program housed within the NY State Office for the Aging.

Who is the Long-Term Care Ombudsman for Nassau County?

Nassau County's regional Long-Term Care Ombudsman Coordinator is Mary Clare Campion, sponsored by Family and Children's Association, located at 377 Oak Street, Fifth Floor, Garden City, NY 11530, phone 516-466-9718. Like Suffolk's coordinator, this office is part of the statewide Long Term Care Ombudsman Program administered under the NY State Office for the Aging.

What's the statewide hotline if I don't know who my local Long-Term Care Ombudsman is?

New York's statewide Long Term Care Ombudsman hotline is 1-855-582-6769. It connects callers to the Office of the State Long Term Care Ombudsman, an independent office housed within the NY State Office for the Aging, which supervises Regional Ombudsman Coordinators, including Suffolk's and Nassau's, across the state.

What kinds of problems should I bring to the Ombudsman versus reporting to Adult Protective Services?

The Long-Term Care Ombudsman Program handles advocacy and complaint resolution for residents already living in a licensed facility, such as a nursing home, assisted living residence, adult home, or family-type home, addressing issues like care quality concerns, rights violations, or disputes with facility staff. Adult Protective Services (APS), by contrast, investigates suspected abuse, neglect, or exploitation of impaired adults living in the community, including those who depend on others for basic needs, and is administered through the county Department of Social Services rather than the Office for the Aging.

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