Knoxville Senior AdvisorDoes Medicare pay for assisted living in Knoxville?
No. Medicare does not pay assisted living rent, meals or personal care in Tennessee or anywhere else, because it covers medical care, not custodial help with daily living.
Medicare does still cover the medical services a resident receives while living in an ACLF: doctor visits, Part D prescriptions, home health visits for a qualifying need, therapy and hospice. Medicare Advantage plans sold in East Tennessee sometimes add small supplemental benefits, but none replaces the monthly assisted living bill.
When does Medicare pay for a nursing home stay?
Medicare Part A covers skilled nursing facility care after a qualifying inpatient hospital stay of at least three days, when a doctor orders daily skilled nursing or therapy; it pays in full for days 1 to 20 and charges a daily coinsurance for days 21 through 100, and pays nothing after day 100.
Observation days in the hospital do not count toward the three inpatient days, which surprises many families after an ER visit at UT Medical Center or Parkwest. Ask the hospital, in writing, whether your parent is an inpatient or under observation. Coverage also ends once skilled care is no longer needed, even before day 100.
Does Medicare cover home health care in Knoxville?
Yes, when a patient is homebound and a doctor certifies a need for intermittent skilled nursing or therapy, Medicare covers home health visits from a certified agency with no copay, including part-time aide help tied to that skilled care.
The state's facility listings show 58 licensed home health agencies and 15 licensed hospices with offices in Knox, Blount, Anderson, Loudon, Sevier, Roane and Union counties. Tennessee licenses home health and hospice agencies, but companion-only or homemaker-only agencies do not appear as a separate category in the HFC facility listings, so check those agencies' training, insurance and background-check practices directly. Home health is not the same as hourly home care: Medicare does not pay for a caregiver to stay for a shift, help with housekeeping alone, or provide supervision. See home health or private home care.
Does Medicare pay for hospice in East Tennessee?
Yes. Medicare's hospice benefit covers comfort-focused care for a patient whose doctor certifies a life expectancy of six months or less if the illness runs its normal course, wherever the patient lives: at home, in an ACLF or in a nursing home.
HFC lists 15 licensed hospices with offices in the seven counties, among them Amedisys Hospice, an Adventa Company, Caris Healthcare, Covenant Hospice, Gentiva (Branch); hospices headquartered elsewhere can also serve East Tennessee addresses. Hospice covers the team, medications and equipment related to the terminal illness, but not room and board in a facility. A resident can leave hospice at any time and return to regular Medicare.
Where can Knoxville families get free Medicare advice?
TN SHIP, the State Health Insurance Assistance Program run by the Tennessee Department of Disability and Aging, gives free, unbiased Medicare counseling at 1-877-801-0044, and ETHRA provides SHIP counseling locally through its Area Agency on Aging and Disability.
SHIP counselors help compare Medicare Advantage and Medigap plans during open enrollment, sort out Part D drug costs, and explain how a skilled nursing stay will be billed. They do not sell insurance.
Side by side
| Medicare pays for | Medicare does not pay for | |
|---|---|---|
| Rehab | Skilled nursing after a three-day inpatient stay, up to 100 days | Long-term custodial nursing home care |
| At home | Intermittent skilled home health for homebound patients | Hourly or overnight caregivers |
| End of life | Hospice care, drugs and equipment | Facility room and board during hospice |
| Assisted living | Medical services residents receive | Rent, meals or personal care |
Sources: Tenn. Comp. R. & Regs. chapters 0720-26, 0720-21 and 0720-18; Health Facilities Commission, TennCare and Department of Disability and Aging pages; CareScout and VA rate tables, as cited above. See our editorial standards.
