Des Moines Senior AdvisorDoes Medicare pay for assisted living or memory care in Des Moines?
No. Medicare does not pay rent, meals or personal care in an Iowa assisted living program or dementia-specific program; it continues to cover a tenant's doctor visits, hospital care, prescriptions under Part D, and home health or hospice delivered in the apartment.
Families sometimes hear that Medicare will cover a few weeks of assisted living after surgery. It does not. What can happen is that Medicare home health nurses and therapists visit a tenant in the program while recovering, the same way they would visit a house.
When does Medicare pay for a skilled nursing facility stay?
Medicare Part A covers up to 100 days of skilled nursing facility care per benefit period, but only after at least three consecutive days as a formally admitted hospital inpatient and only while daily skilled nursing or therapy is still needed.
The first 20 days are covered in full and days 21 to 100 carry a daily coinsurance; most stays end well before day 100 because progress plateaus. Observation days at UnityPoint, MercyOne or Broadlawns do not count toward the three inpatient days, so ask for status in writing. Medicare Advantage plans set their own rules and often require prior authorization.
Does Medicare pay for home health care in Des Moines?
Yes, for a patient who is homebound and needs intermittent skilled nursing or therapy under a doctor's plan of care; Medicare pays the full cost of covered visits from a Medicare-certified home health agency.
DIAL lists 20 home health agencies, 11 hospices and 3 inpatient hospice houses with offices in the six metro counties. Covered home health can include part-time aide visits for bathing while skilled care is also being provided, but not round-the-clock care, homemaker services alone or meals. Those come from private pay, the Elderly Waiver or PACE.
Does Medicare pay for hospice?
Yes. Medicare's hospice benefit covers the hospice team, medications and equipment related to the terminal illness for a patient whose doctor certifies a life expectancy of six months or less if the illness runs its normal course.
DIAL's roster shows 11 licensed hospices with metro offices and 3 inpatient hospice houses: EveryStep Bright - Kavanagh House (Des Moines, 24 beds), EveryStep Kavanagh House (Des Moines, 15 beds), UnityPoint Hospice - Taylor House (Des Moines, 12 beds). Hospice can be delivered at home, in an assisted living program, in a nursing facility or, for short periods of symptom control, in an inpatient setting. Medicare does not pay room and board in a nursing home or assisted living while a patient is on hospice.
Where can Des Moines families get free Medicare help?
From SHIIP, the Senior Health Insurance Information Program run by the Iowa Insurance Division, whose trained counselors compare Medicare plans for free, and from Aging Resources of Central Iowa, which hosts counseling in the metro.
The fall open enrollment period, October 15 to December 7, is the time to compare Part D and Medicare Advantage plans, especially if a parent's medications or doctors changed. Check that a plan's network includes the hospitals and skilled nursing facilities your family would actually use.
Side by side
| Medicare pays for | Medicare does not pay for | |
|---|---|---|
| Rehab | Skilled nursing after a qualifying 3-day inpatient stay | Long-term custodial nursing home care |
| At home | Intermittent skilled home health | Hourly or overnight aides |
| Assisted living | Medical services delivered to the tenant | Rent, meals or personal care |
| End of life | Hospice team, drugs and equipment | Room and board during hospice |
Drawn from Iowa Code chapter 231C, 481 IAC chapters 67 and 69, Iowa HHS and DIAL publications, CareScout, CMS, the VA and the aging agencies cited in the text; our editorial standards explain how we check them.
