Does Medicare Cover Nursing Home or Long-Term Care?

Medicare does not pay for long-term nursing home care. It covers up to 100 days of skilled nursing facility care per benefit period — and only after a qualifying hospital stay. It does not cover custodial care: ongoing help with bathing, dressing, or eating. For long-term care, most people rely on Medicaid, long-term care insurance, or their own savings. This surprises many families, so let's walk through it.

What the 100-Day Skilled Nursing Benefit Covers

After you stay in a hospital as an inpatient for at least three days, Medicare Part A covers up to 100 days in a Medicare-approved skilled nursing facility (SNF). These facilities provide nursing care and rehabilitation, like physical therapy or wound care, for people recovering from surgery, illness, or injury.

Coverage ends when you no longer need daily skilled care — or when you use all 100 days in a benefit period, whichever comes first. Many stays end well before day 100, because coverage depends on needing skilled care every day, not just needing a place to stay.

For the full picture of hospital and SNF coverage, see Medicare Part A: Hospital Insurance.

What You Pay During Those 100 Days

The benefit is not free the whole way through:

• Days 1–20: You pay nothing for covered SNF care, if you meet the requirements (like the three-day hospital stay).
• Days 21–100: You pay a set amount per day. The daily amount changes each year — check Medicare.gov for current costs.
• After day 100: You pay all costs.

Days count per benefit period, not per year. A benefit period starts when you enter a hospital or nursing facility. It ends 60 days after you leave and don't return for more care. When a new benefit period begins, you get a fresh set of covered days. Understanding Your Costs explains how Medicare cost-sharing works overall.

Skilled Care vs. Custodial Care: The Line That Decides Everything

This is the most important distinction in long-term care coverage. Medicare only covers skilled care — care that a nurse, therapist, or licensed professional needs to provide.

If you need help with daily living (bathing, dressing, eating) but not skilled nursing or therapy, that's custodial care — and Medicare doesn't pay for it. A nursing home stay for custodial reasons, not skilled rehab, is not covered by Medicare. That's true no matter how long you've paid into Medicare, and it's the gap that catches many families off guard.

So Who Pays for Long-Term Care?

Medicaid is the main program that pays for long-term custodial care, in facilities or at home. But it's only for people with low income and limited assets, and the rules vary by state:

• Nursing facility care: Medicaid pays for long-term nursing facility care when medical needs are met. Residents must first spend down their assets to their state's Medicaid limit. Our guide to Medicaid spend-down and look-back rules explains how that works.
• Care at home: States offer Home and Community-Based Services (HCBS) waivers. These let Medicaid pay for in-home help, day programs, and assisted living. Some have long waiting lists.
• Other options: Long-term care insurance and personal savings. Many families pay out-of-pocket, or plan ahead with an elder law attorney.

See Medicaid Eligibility, Waivers & Long-Term Care for the full picture, and our State Medicaid Directory to find your state's rules.

What About Medigap and Medicare Advantage?

Medigap (Medicare Supplement) plans do not cover long-term care. They help with Medicare's cost-sharing for services Medicare already covers. See Medigap Plans.

Medicare Advantage plans must cover what Original Medicare covers, including the SNF benefit. Some add extras like meal delivery or rides to medical visits, but they do not cover long-term custodial care either.

If you qualify for both Medicare and Medicaid, you are dual eligible. Medicaid can then pay for services Medicare doesn't cover — including long-term care. See Dual Eligible: Medicare and Medicaid.

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