What Is Assisted Living? Benefits, Requirements And Costs (2024)

Assisted living communities are for older adults who want to remain independent in a home-like setting but need non-medical assistance with activities of daily living (ADLs), such as eating, bathing, dressing, maintaining good hygiene and toileting. The person in assisted living typically pays monthly rent for a private apartment or room and an additional fee for the level of care needed.

Residents generally have access to shared common areas. Depending on the community, shared areas may include dining and activity rooms, a cinema room, a library, a pool and walking trails or other nature settings on the grounds. Assisted living communities range from those offering basics like daily meals and activities to those with luxury accommodations and amenities, such as spas and bars.

Assisted living communities are typically equipped with 24-hour on-site staff and provide up to three prepared meals a day, as well as housekeeping and some transportation services.

Types of Assisted Living Facilities

Assisted living communities range in size from as few as 25 residents to upward of 120 people. They can also be called adult care facilities or residential facilities, but over the last 20 years, assisted living communities have moved away from a “facility” setting to a more home-like, community feel where residents can benefit not just physically, but emotionally and mentally as well.

Assisted living residences allow a person to continue living independently, even with chronic health conditions, mild memory loss or mobility issues. However, assisted living offers other benefits to the resident as well, such as letting someone else worry about home maintenance and repairs.

“Some people move to assisted living because their physical health is declining and they want to not have to cook, clean and rake leaves anymore,” says Jennifer L. FitzPatrick, a licensed certified clinical social worker, author of Cruising Through Caregiving: Reducing The Stress of Caring For Your Loved One and gerontology instructor at Johns Hopkins University in Baltimore. “At the same time, assisted living communities often provide ample activities or events that can enhance physical health, mental stimulation and wellness, social connections and a sense of community.

“More and more data suggests that loneliness and isolation are very bad for physical, mental and cognitive health,” says FitzPatrick. “Just interacting with staff and other residents every day, even if they are not overly engaged in onsite activities, is very good for older adults.” Most assisted living communities also contract with mental health providers who may offer on-site psychotherapy and psychiatric consults, says FitzPatrick.

Most assisted living communities charge basic monthly rent for the resident’s apartment or room. The resident pays additional fees for help with activities of daily living, mobility or other services, as needed. Depending on the community’s pricing model, assisted living rent typically (but not always) includes the following services:

• Private living quarters. Generally, assisted living quarters range from a basic studio or room to a one-bedroom or two-bedroom apartment with a kitchenette, sink and microwave. Some assisted living communities offer more spacious apartments than others and include a greater number of amenities for a higher amount of rent than communities with more limited space and services.
• Home maintenance, repairs and landscaping. When your dishwasher, air conditioner or another appliance breaks, management takes care of the repairs. Landscaping services are typically included as well.
• An emergency medical alert system. Many assisted living apartments and studios come with an emergency medical alert system to connect with staff or 911 immediately in the event of an emergency.

• Nutritious daily meals. Most assisted living communities include up to three meals a day in the price of the resident’s rent. Residents may also have access to snacks in the dining area throughout the day and night.
• Laundry and housekeeping services.
• Scheduled transportation. Many assisted living communities offer free scheduled transportation to doctor’s appointments, along with trips to the grocery store, pharmacy and other essential errand locations.
• Activities and outings. Activities may include educational, cultural or religious events or services, trips to plays or concerts, guest speakers and other opportunities for residents to socialize and enjoy mental stimulation.
• Classes. An assisted living community may offer classes for fitness, yoga or other forms of physical exercise. Residents may also be able to take classes on painting, writing, technology, home safety or other topics.

The following services in assisted living are typically provided (if available) for an additional fee:

• Help with activities of daily living. Residents typically pay a fee on top of rent based on the level of care needed for help with ADLs necessary to continue living independently, such as eating, bathing, toileting or organizing and keeping track of medication schedules.
• On-site healthcare or pharmacy access. If an assisted living facility has an on-site doctor and/or pharmacy, you may have to pay an extra facility fee for these services.
• Beauty shop and barber services.
• Upgraded WiFi services. Assisted living rent may include basic WiFi, but if you prefer a faster connection, you must usually arrange it with the provider of your choice.

The cost of assisted living varies greatly by city and state. The national median cost for an assisted living facility is around $4,300 a month, according to the 2020 Genworth Cost of Care Survey^[2]2020 Genworth Cost of Care Survey. Genworth. Accessed 6/22/2021. . In some states or cities, however, the cost can be much higher.

For example, the 2020 median cost for an assisted living facility in Seattle was $6,750 a month, and the median cost in Washington, D.C. was $6,000 a month. Meanwhile, assisted living monthly costs were lower than the national median in other cities, such as Miami ($3,500), St. Louis ($3,750) and Charleston, South Carolina ($3,600).

Does Insurance Cover Assisted Living?

Most health insurance policies don’t provide coverage for assisted living. However, if you have long-term care insurance, your policy may cover assisted living costs. If you meet income eligibility requirements and you (or a spouse) qualify as a wartime military veteran, you may also be able to receive a monthly monetary benefit to help pay for assisted living through the Veterans Administration’s Aid and Attendance program.

Does Medicare Cover Assisted Living?

Medicare doesn’t cover long-term care costs for assisted living or nursing home care. Medicare typically covers only short-term, in-home or residential care while recovering from a hospital stay.

Does Medicaid Cover Assisted Living?

Medicaid is a state program, and Medicaid benefits for assisted living vary by state. Generally, if the resident meets state income eligibility guidelines and the assisted living community is licensed by the state and accepts Medicaid, the program pays for “long-term care services” like personal care but doesn’t pay for the room and board portion of assisted living costs.

There are plenty of assisted living directories online. However, most of these directory companies typically receive monetary compensation for referrals and may not list all assisted living communities in your area. To get a true picture of what’s available where you live, perform your own online search by typing “assisted living” and your city name into a search engine.

Staff at most assisted living communities will gladly take you on a tour of apartments and grounds, answering questions you may have about pricing and amenities. Want to get an overview of different types of assisted living communities? Sign up for free “senior living bus tours” of different communities in your area.

“Talk to other residents and their family members—and not just the ones provided as references by the community,” says FitzPatrick. “Chat up those you see during your tours and ask them to sit down for 15 minutes to tell you what they like—and don’t like—about the assisted living community. Keep in mind that no community is perfect when having these discussions.”

FitzPatrick also recommends speaking with direct care staff, such as nursing assistants, program and activities staff, housekeepers and dining servers who will have the most contact with you or your loved one.

“Ask them how long they’ve worked for the community. Ask them what they like about their job,” says FitzPatrick. “Listen to their answers but also pay attention to their facial expressions and body language. These conversations can really help inform your decision.”