Colorado Springs Senior AdvisorDoes Medicare pay for assisted living in Colorado Springs?
No. Medicare does not pay rent or personal care in an assisted living residence; it does pay for doctors, hospital care, medically necessary home health visits, therapy and hospice that a resident receives while living there.
Families are often told otherwise by a well-meaning friend. The confusion comes from the skilled nursing benefit, which covers a short rehab stay in a nursing home after a hospital admission, and from Medicare Advantage plans that add small extras. Neither pays for an assisted living apartment.
How much nursing home care does Medicare 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 full coverage for days 1 to 20 and a daily coinsurance from day 21; it stops when skilled care is no longer needed, often well before day 100.
Time spent under observation status does not count toward the three inpatient days, so ask the hospital in writing whether your parent is admitted or under observation. Medicare Advantage plans may waive the three-day rule but require their own authorizations. Most Colorado Springs nursing homes on our directory are certified for Medicare.
What does TRICARE For Life add for military retirees in Colorado Springs?
TRICARE For Life is secondary coverage for Medicare-eligible military retirees and family members who have Medicare Parts A and B; it generally pays what Medicare does not for Medicare-covered services, including the skilled nursing coinsurance after day 20, but it does not cover long-term custodial care.
With Fort Carson, Peterson and Schriever Space Force bases, Cheyenne Mountain and the Air Force Academy in El Paso County, a large share of local retirees carry TRICARE For Life. Keeping Part B is essential: dropping it ends TRICARE For Life coverage. For long-term help, retirees look to VA benefits, long-term care insurance (including the Federal Long Term Care Insurance Program for those enrolled) and Health First Colorado.
Does Medicare pay for home care in Colorado Springs?
Medicare pays a certified home health agency for part-time skilled nursing, therapy and some aide visits when a doctor certifies the person is homebound and needs skilled care; it does not pay for ongoing non-medical help such as bathing, meals or supervision on their own.
CDPHE's data shows 49 home health agencies and 15 hospices with offices in El Paso and Teller counties. Non-medical help is private pay at around $42 an hour in Colorado, or waiver-funded for Health First Colorado members. Hospice, which Medicare covers fully for terminal illness, can be provided at home, in assisted living or in a nursing home.
Side by side
| Medicare and TRICARE For Life cover | They do not cover | |
|---|---|---|
| Nursing home | Short skilled rehab after a qualifying hospital stay | Long-term custodial care |
| Home | Part-time skilled home health for homebound patients | Ongoing personal care or companionship |
| Assisted living | Medical services received there | Rent, meals or personal care |
| End of life | Hospice wherever the person lives | Room and board in a facility |
Drawn from 6 CCR 1011-1 Chapter 7, CDPHE and HCPF publications, CareScout, CMS, the VA and the Pikes Peak Area Agency on Aging; our editorial standards explain how we check them.
