Does Medicare pay for assisted living in Virginia?
No. Original Medicare and Medicare Advantage plans do not pay for room, board or personal care in a Virginia assisted living facility, or for long-term custodial care in a nursing home; families pay privately or use the Auxiliary Grant, VA benefits, long-term care insurance or Medicaid where it applies.
Medicare still covers a resident's doctor visits, hospital care, therapy and prescriptions under Part D while they live in assisted living -- just not the facility itself.
| Medicare | Medicaid (Cardinal Care) | |
|---|---|---|
| Assisted living | Not covered | Room and board not covered; AG is separate |
| Long-term nursing home | Not covered | Covered if eligible |
| Home care | Skilled, intermittent only | Personal care through the CCC Plus Waiver |
When does Medicare cover a nursing home stay after a Richmond hospital admission?
Medicare Part A can cover skilled nursing facility care after a qualifying inpatient hospital stay when daily skilled nursing or therapy is needed, for a limited number of days per benefit period; time spent under observation status does not count toward the qualifying stay.
Ask the hospital in writing whether the patient is admitted as an inpatient or held under observation. At VCU, Bon Secours or HCA hospitals the case manager can tell you, and the difference can decide who pays for rehab afterward.
What home health and hospice care does Medicare cover?
Medicare covers intermittent skilled home health -- nursing visits and physical, occupational or speech therapy for a homebound patient under a doctor's plan -- and covers hospice care for a terminal illness, including the hospice team, related medications and equipment, but not a full-time caregiver or room and board.
Non-medical help with bathing, meals and supervision is private pay unless Medicaid's CCC Plus Waiver or a VA program covers it.
How do Medicare Advantage plans affect rehab and home care for Richmond seniors?
Medicare Advantage plans must cover the same skilled nursing, home health and hospice benefits as Original Medicare, but they often require prior authorization, use provider networks and may set different cost-sharing, so a Richmond family should confirm which rehab facilities and home health agencies are in network before discharge.
Hospice is the exception: once a Medicare Advantage member elects hospice, Original Medicare generally pays the hospice. Some Advantage plans also offer limited extra benefits such as meal delivery after a hospital stay or a small number of in-home support hours, which are worth asking about but do not replace long-term care.
For people with both Medicare and Medicaid, Virginia's Cardinal Care plans coordinate Medicaid long-term services, such as CCC Plus Waiver personal care, alongside Medicare.
Does Medicare pay for adult day care?
No. Original Medicare does not cover adult day care; in Virginia the CCC Plus Waiver covers adult day health care for eligible Medicaid members.
Last verified: October 2026
