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What Medicare Does and Does Not Pay For

Medicare covers short skilled nursing stays, home health and hospice. It does not pay for assisted living or custodial care.

HomeCosts & PayingWhat Medicare Does and Does Not Pay For
Short answer

Medicare does not pay for assisted living, memory care, or long-term custodial care anywhere in Texas. It covers limited skilled nursing facility stays after a qualifying hospital admission, intermittent skilled home health, and hospice.

What Medicare covers

  • Skilled nursing facility care after a qualifying inpatient hospital stay, for a limited period, when skilled care is needed daily. This is rehabilitation, not long-term placement.
  • Home health that is intermittent and skilled — nursing visits, physical, occupational or speech therapy. Not a caregiver who stays with your parent.
  • Hospice — the hospice team, medications related to the terminal diagnosis, and equipment. Not room and board in a facility.

What Medicare does not cover

  • Assisted living rent, meals, or personal care
  • Memory care
  • Long-term custodial nursing home care
  • Non-medical home care, companionship, or homemaker services
  • Adult day care
The observation status trap. A Medicare skilled nursing benefit requires a qualifying inpatient hospital admission. Time spent under “observation status” does not count, even if your parent slept in a hospital bed for two nights. Ask the hospital directly whether your parent is admitted as an inpatient or under observation, and ask in writing.
What senior care costs. The Texas median is $5,666 a month for assisted living and $7,604 for a private nursing room. No Austin-specific median is published by any primary source. Read the full explanation →

Questions Austin families ask

Who do I call first when a parent in Austin suddenly needs care?

Start with the Aging and Disability Resource Center of the Capital Area at 855-937-2372, weekdays 8 to 5. It's the front door for Texas long-term services and supports across Travis, Williamson, Hays, and seven other counties. Appointments are strongly suggested. You can also dial 2-1-1.

How do I get Meals on Wheels in Austin?

Call Meals on Wheels Central Texas at 512-477-2273, weekdays 8 to 5. Eligibility requires being primarily homebound, unable to easily prepare nutritious meals, without consistent daytime help, and able to accept delivery in the Greater Austin area. Enrollment includes case management. Rural counties are served separately.

What free transportation is available for Austin seniors?

Several options. Senior Access, formerly Drive a Senior, provides free volunteer-driver rides. The City of Austin Parks and Recreation Senior Transportation Program serves residents 60 and older inside city limits. CapMetro Access offers ADA paratransit, and CapMetro gives a half-price Reduced Fare ID at 65.

Is there free help for dementia caregivers in Austin?

Yes. AGE of Central Texas at 512-451-4611 offers a free early-stage memory loss program, caregiver support groups, and CaregiverU evidence-based courses at no charge. It also lends wheelchairs, walkers, and shower benches free. Adult day health care with dementia-trained staff runs in Austin and Round Rock.

Where can I borrow a wheelchair or walker in Austin for free?

AGE of Central Texas runs a health equipment lending program providing wheelchairs, walkers, shower benches, and other assistive devices at no cost. Call 512-451-4611 or visit 7640 Guadalupe Street, Austin. This is often faster than waiting on Medicare durable medical equipment authorization after a hospital discharge.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in the Austin area that actually fit your situation and budget. It is free, and there is no obligation.

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