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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.

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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. Minnesota's CareScout-cited median is roughly $6,573/month for assisted living (unverified, third-party sourced) -- no metro-specific or memory-care figure exists anywhere. Read the full explanation →

Questions families ask

What senior care options exist in Washington County?

Washington County, including Woodbury and Stillwater along the St. Croix River valley, has the metro's highest share of residents age 65+ at 18.8% — meaning it is, proportionally, the fastest-aging of the seven Twin Cities metro counties. It uses the same statewide Trellis, Senior LinkAge Line, MDH licensing, and MAARC resources as the rest of the metro.

Is care different in Bloomington versus other Hennepin County suburbs?

No — Bloomington operates under the identical Minnesota statewide licensing (Chapter 144G), Medicaid waiver (Elderly Waiver/Alternative Care), and abuse-reporting (MAARC) framework as every other city in Hennepin County and the broader metro. What varies city to city is the local supply, style, and pricing of individual communities, not the underlying regulatory or funding structure.

What's the difference between assisted living and memory care in Minnesota?

Assisted living (Minn. Stat. 144G.10, subd. 2(a)) provides housing plus health-related and supportive services for residents who need help with daily activities but not specialized dementia care. Memory care requires the separate 'assisted living facility with dementia care' license (subd. 2(b)), mandatory dementia-specific staff training (Minn. Stat. 144G.83), and a secured unit with a required written pre-admission disclosure (Minn. Stat. 325F.72).

What's the difference between the Elderly Waiver and Alternative Care in Minnesota?

The Elderly Waiver (EW) is a federal-state Medicaid HCBS waiver requiring the applicant to already be Medical Assistance eligible, while Alternative Care (AC) is a state-only-funded program (no federal match) for seniors who need EW-equivalent services but aren't yet financially MA-eligible. Both use a similar service array and cost cap and never pay room and board.

How does a nursing home differ from assisted living in Minnesota?

Nursing homes provide 24-hour skilled nursing care for residents with significant medical needs and are licensed and regulated separately from assisted living, with their own Nursing Home Report Card. Assisted living, licensed under Chapter 144G, serves residents who need help with daily activities and some health-related services but not continuous skilled nursing oversight, and is generally less expensive.

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