Does Medicare fully cover nursing home care, and are there alternatives?

Question

Christopher Boyd · Accepted Answer

In 2025, Medicare Part A is Limited to only 20 days of full Skilled Care and partial co-pay of up to 100 days total, per benefit period, when the senior leaves the inpatient 3-day minimum hospital admission stay. This is limited to Skilled Care Only. Not residential nursing home/long term care stay.

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.

Larry Dalton · Answer

Traditional Medicare and nursing home coverage provide only short-term coverage. If one needs nursing home care services in the future, it is important to get long-term care insurance.

Tom Rogala · Answer

No.  You need a long term care policy.  The younger and healthier you are the cheaper it will be.  Some go with advantage over medigap and use the saving to fund LTC.

Mary Turner · Answer

Medicare covers up to 100 days of custodial care which is rehab for the most part.  Medicare does NOT pay for long term care. 

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.

Nathan Curry · Answer

Long-term nursing home care is not fully covered by Medicare, as is commonly believed. Medicare Part A may cover a short stay in a skilled nursing facility, but only under certain conditions, such as following a qualifying hospital stay and requiring skilled care. Even then, the coverage is limited to 100 days. The first 20 days are completely covered, but on day 21, there is a daily copay.

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.

Edward Allen · Answer

Original Medicare Part A Hospital benefits cover up to a maximum of 100 days. 
Alternatives are Medicaid, or a Long Term Care policy. Assisted Living Facilities, Senior Care Apartments

Gregg Matheny · Answer

No it does not. Yes Medicare does help out with care from a skilled nursing facility. Days 1-20 Are covered in full by Medicare. Days 21 through 100 there will be a set co-pay of a little over $200 per day. After day, 100 you are responsible for all costs. Unfortunately Medicare doesn’t cover any type of custodial care or long-term care.

Answered by Gregg Matheny on March 26, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

Leslie Helene Sussman · Answer

Medicare covers Medically necessary part-time or intermittent skilled nursing home care services and more (ei Physical and Occupational Therapy).   

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.

Sean Davis · Answer

Medicare does not fully cover nursing home care. It only provides limited coverage for skilled nursing facility care under certain conditions, such as after a qualifying hospital stay of at least three days. Even then, Medicare typically covers only the first 20 days fully, with beneficiaries responsible for a daily copayment for days 21 to 100.

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.

Harold Randolph · Answer

Medicare doesn’t cover nursing home care. Medicare does cover the first 20 days of skilled nursing care. Afterwards there is a daily copay for being facilitated. There are options to prepare for the inevitability of needing rehab services. 
Reach out to a broker to look at long term care and short term care options while you’re healthy.

Does Medicare fully cover nursing home care, and are there alternatives?

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Does Medicare fully cover nursing home care, and are there alternatives?

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