What Medicare does and doesn't pay for

Does Medicare pay for assisted living in Boise?

No: Medicare does not pay for assisted living rent, meals or personal care in a RALF or a certified family home, though it can cover doctor visits, therapy, home health visits and hospice for a resident living there.

Families are often surprised by this after a hospital stay. Assisted living is paid privately, by long-term care insurance, by VA pension or by Idaho Medicaid for eligible residents.

How long does Medicare pay for a nursing home stay after a Boise hospital stay?

Medicare Part A can cover up to 100 days of skilled nursing facility care per benefit period after a qualifying inpatient hospital stay of at least three days, with no coinsurance for days 1 to 20 and a daily coinsurance from day 21; coverage stops when skilled care is no longer needed.

“Observation” days in the hospital do not count toward the three-day inpatient requirement, so ask the hospital how your parent is classified. Most Treasure Valley nursing homes take short-stay Medicare residents; their CMS short-stay ratings are on our facility pages.

Does Medicare cover home health and hospice in Idaho?

Yes: Medicare covers intermittent skilled home health visits for homebound patients under a doctor's plan, and hospice care for people with a life expectancy of six months or less who choose comfort care, at home, in a RALF or in a nursing home.

CMS's provider files list 10 Medicare-certified home health agencies and 17 hospice providers with offices in the Treasure Valley, most of them in Meridian and Boise; agencies serve clients well beyond their office city.

Do Idahoans with both Medicare and Medicaid have special plans?

Yes: Idaho enrolls many adults who have both Medicare and Medicaid in coordinated managed care plans, and IDHW can explain which plan options apply in each county; ask before changing a Medicare plan, because the choice affects long-term care benefits.

SHIBA, Idaho's Senior Health Insurance Benefits Advisors program, gives free Medicare counseling; the Area 3 agency can connect you.

Does a Medicare Advantage plan change these rules?

Medicare Advantage plans must cover the same basic benefits but can require prior authorization and use networks for skilled nursing and home health, so check the plan's rules before choosing a rehab home.