Does Medicare fully cover nursing home care, and are there alternatives?
Answered by 26 licensed agents
For long-term care in nursing homes, Medicare does not provide coverage. Alternatives for covering these costs include Medicaid for those who qualify based on income and assets, long-term care insurance, or personal savings. It's important to explore different options well in advance to ensure a comprehensive plan for potential long-term care needs.
Answered by Sean Davis on March 26, 2025
Broker Licensed in NY, LA, MD & 6 other states
Answered by Larry Dalton on March 26, 2025
Broker Licensed in OK & TX
Answered by Misty Bolt on May 26, 2025
Agent Licensed in TN, AL, AR & 45 other states
Medicare provides zero Long Term Nursing Home Care funding. Per the 2025 Medicare and You Handbook, there are only TWO Nursing Home coverage options: Medicaid or private Long Term Care Insurance. Further, the Medicare Book recommends seniors plan for their long-term care NOW to ensure they can get the care they want, in the setting they want, in the future. Medicaid Spend Down laws can vary state by state and change each year.
Long Term Care Insurance policies written in 2025 and beyond can provide coverage at home, adult day care, assisted living, hospice, nursing home care, etc, without having to spend down ones assets and keep help control of their money and indepence.
Answered by Christopher Boyd on March 4, 2025
Agent Licensed in IN, KY, MI, OH, PA & TN
Answered by Kelsey Hentzen on April 28, 2025
Broker Licensed in KS & MO
Answered by Michael Andrews on May 27, 2025
Broker Licensed in CT
Answered by Mitch Anderson on June 24, 2025
Agent Licensed in MN, IA & WI
Here's a more detailed explanation:
Medicare's Coverage:
Medicare Part A can cover skilled nursing facility (SNF) care for a limited time (up to 100 days) if you meet certain conditions, including a qualifying hospital stay of at least three days.
Custodial Care:
Medicare typically doesn't cover custodial care, which is the type of care that helps with activities of daily living (ADLs) like bathing, dressing, and eating.
Skilled Nursing Care:
Medicare may cover skilled nursing care in a nursing home, or in your home (with home health care), if you need short-term skilled care for an illness or injury and you meet certain conditions.
Medicaid:
If you need long-term care and don't qualify for Medicare, you might explore Medicaid, which can help cover long-term care costs in a nursing home.
Other Options:
Consider long-term care insurance, or explore veterans benefits if applicable. There are other options available that will assist. For the most part it entails preplanning not waiting until the services are needed.
Answered by Michael Ryan on April 8, 2025
Broker Licensed in CA, AZ, CO & 7 other states
Options for long term care include Medicaid, self pay, long term care policies, life insurance with a terminal clause rider, etc.
Which option you choose depends on many factors such as assets, health, and more.
Answered by Mary Turner on March 28, 2025
Broker Licensed in FL
Answered by Tom Rogala on April 2, 2025
Agent Licensed in MI, AR, AZ & 10 other states
Medicare only covers up to 100 days in a skilled nursing facility, and only if you meet very specific conditions:
You must have had a qualifying hospital stay
You need daily skilled care (not just help with bathing or eating)
And after 20 days, you’ll start paying a daily copay. After 100 days, you pay everything. Medicare, Medicare Advantage, nor Medicare Supplement will contribute anything towards skilled nursing after 100 days.
This is where families often face emotional and financial pressure.
Round-the-clock care at home or in a facility can cost over $150,000 per year, and it’s not unusual for someone to need that care for months — or years.
What can you do instead?
I strongly recommend planning ahead with Recovery Care or Short-Term Care insurance — affordable policies that cover up to a year of skilled nursing, or home care giving you time, flexibility, and relief when it's most needed.
For longer-term coverage, there are:
Hybrid life insurance or annuity policies that include long-term care benefits.
State Medicaid planning strategies (for those who qualify) may be available to some.
The key is planning before a crisis hits — and that’s what I help my clients do. It’s not just about picking a Medicare plan — it’s about protecting your future dignity, choices, and peace of mind.
Answered by Yasmine Lopez on June 6, 2025
Broker Licensed in UT, AL, AZ & 17 other states
Answered by Sandra Bailey on May 8, 2025
Broker Licensed in TN, AL, AR & 13 other states
Medicare does not cover long-term custodial care, which includes assistance with daily tasks such as bathing, dressing, and eating. Long-term care insurance, Medicaid (if you qualify financially), hybrid life insurance policies with long-term care benefits, or personal savings and assets are all options for paying for this type of care.
Answered by Nathan Curry on March 25, 2025
Broker Licensed in FL, AL, AZ & 20 other states
Alternatives are Medicaid, or a Long Term Care policy. Assisted Living Facilities, Senior Care Apartments
Answered by Edward Allen on March 4, 2025
Broker Licensed in CA & TN
Answered by Steven Bleicher on April 11, 2025
Broker Licensed in AZ
1) Purchasing a long term care policy but it may not be feasible due to the cost and current age . Most people purchase these policies in their 50s as a precautionary measure and where affordability is more likely.
2) Applying for Medicaid but this would require a “spend down” of your assets to no more than $2,000 a month. The best advice is to consult an elder law attorney to see if this is a viable option.
3) If the person in need of nursing home care is a homeowner, selling the house and using the proceeds to pay the cost to reside there is an option since a majority of these facilities are private pay.
Answered by Timothy Brown on June 7, 2025
Broker Licensed in PA, CT, DE & 15 other states
Alternatives to Medicare for paying for nursing home care include Medicaid, long-term care insurance, and private pay.
Some life insurance policies or even annuity products offer living benefits that are built in to the plan that will help cover SNF expenses.
Answered by Diana Garner on May 2, 2025
Broker Licensed in KY, FL, IN, OH & TN
Answered by Gregg Matheny on March 26, 2025
Agent Licensed in AZ & UT
There are Long-term care resources and local services available.
Medicare typical covers Hospice care.
In your Medicare and You Handbook 2025 page 43-44. If you do not have a Medicare and You handbook - I can email you a digital copy.
Answered by Leslie Helene Sussman on March 31, 2025
Broker Licensed in NJ, FL & PA
Answered by Dionisio Guillermo on May 22, 2025
Agent Licensed in HI
Reach out to a broker to look at long term care and short term care options while you’re healthy.
Answered by Harold Randolph on April 3, 2025
Broker Licensed in MI, IN, KY & OH
Answered by Vachik Chakhbazian on June 1, 2025
Agent Licensed in CA, AL, AR & 22 other states
Answered by Andrew Kramer on May 23, 2025
Agent Licensed in FL
Answered by Babs Atwell on June 16, 2025
Broker Licensed in OH
Medicaid is a joint federal and state program that helps pay health care costs if you have limited income and (in some cases) resources and meet other requirements. Some people qualify for both Medicare and Medicaid. Most, but not all, nursing homes accept Medicaid payment. Even if you pay out-of-pocket or with long-term care insurance, you may eventually "spend down" your assets while you’re at the nursing home, so it’s good to know if the nursing home you chose will accept Medicaid.
Answered by Patrick Stinson on April 28, 2025
Broker Licensed in TX, AR, AZ & 9 other states
Answered by April Ryan on June 9, 2025
Broker Licensed in NC, SC & VA
Tags: Coverage
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