Does Medicare cover nursing home care?

Usually not covered

Medicare does not cover long-term nursing home stays for custodial care — it only covers up to 100 days in a skilled nursing facility for rehab after a qualifying hospital stay.

Covered when You had a qualifying inpatient hospital stay of at least 3 days and need skilled nursing or rehab care in a Medicare-certified SNF within a short window afterward — Medicare covers up to 100 days per benefit period, with coinsurance after day 20.
Not when The stay is for long-term custodial care (ongoing help with daily living) rather than short-term skilled rehabilitation after a hospitalization.
Not when You've exhausted the 100-day skilled nursing facility benefit for the current benefit period.

Verified 2026-10-10Reviewed by Tom Kazarian, former VP at eHealth6 primary sourcesHow verdicts are made

What flips the answer

Covered when
You had a qualifying inpatient hospital stay of at least 3 days and need skilled nursing or rehab care in a Medicare-certified SNF within a short window afterward — Medicare covers up to 100 days per benefit period, with coinsurance after day 20.
Not covered when
The stay is for long-term custodial care (ongoing help with daily living) rather than short-term skilled rehabilitation after a hospitalization.
Not covered when
You've exhausted the 100-day skilled nursing facility benefit for the current benefit period.

Key facts

Verdict: Usually not covered
Applies to: nursing home care · Medicare
Covered when: You had a qualifying inpatient hospital stay of at least 3 days and need skilled nursing or rehab care in a Medicare-certified SNF within a short window afterward — Medicare covers up to 100 days per benefit period, with coinsurance after day 20.
Not covered when: The stay is for long-term custodial care (ongoing help with daily living) rather than short-term skilled rehabilitation after a hospitalization.
Verified: 2026-10-10 · 6 primary sources

The nursing home question is one of the biggest and most consequential gaps in Medicare. Original Medicare does not pay for long-term custodial nursing home care — the kind of ongoing help with daily living (bathing, dressing, eating, mobility) that most people mean when they ask whether Medicare will pay for a nursing home.

What Medicare does cover is short-term care in a skilled nursing facility (SNF), and only under specific conditions: you must have had a qualifying inpatient hospital stay of at least 3 days, be admitted to the SNF within a short window afterward, and need skilled nursing or rehabilitation services related to that hospital stay. Coverage is capped at 100 days per benefit period, with coinsurance starting after day 20.

Because of this gap, long-term nursing home care is typically paid for out of pocket, through long-term care insurance, or eventually through Medicaid once a person's income and assets are low enough to qualify under their state's rules.

What people typically pay

With coverage

For a qualifying skilled nursing stay in 2026, you pay $0 for days 1–20 (after any applicable Part A deductible), then $217 per day for days 21 through 100, after which Medicare pays nothing. Medigap or a Medicare Advantage plan can reduce or eliminate that day 21–100 coinsurance.

Without coverage

Long-term custodial nursing home care is paid entirely out of pocket unless you have long-term care insurance or qualify for Medicaid. Private nursing home costs vary widely by state, facility, and level of care and can run into the thousands of dollars per month.

Nursing home pricing varies dramatically by state and region, and whether a stay is 'skilled' or 'custodial' — not the facility name — determines what, if anything, Medicare pays.

How to actually get it covered

Confirm the hospital stay was a formal inpatient admission lasting at least 3 consecutive days — time under 'observation status' doesn't count toward the 3-day rule. Ask the hospital for your status in writing; hospitals must give you a Medicare Outpatient Observation Notice if you're not admitted.
Enter a Medicare-certified skilled nursing facility generally within 30 days of leaving the hospital, for a condition that was treated during the stay or arose while you were being treated for it.
Make sure the facility documents a daily skilled need — nursing care or therapy that only skilled staff can provide. Coverage ends the day the need becomes custodial (help with bathing, dressing, eating), even if you're still in the building.
Know the costs before day 21: days 1–20 cost you $0, days 21–100 cost $217 a day in 2026, and after day 100 you pay everything. Several Medigap plan letters pay the daily SNF coinsurance; check your plan's benefit chart.
For long-term custodial care, start the Medicaid conversation early. Eligibility is financial and set by your state, with scrutiny of asset transfers in the years before you apply, and the application takes time — your Area Agency on Aging (Eldercare Locator) and SHIP counselors can explain your state's rules at no charge.
Ask about alternatives to a facility: Medicaid home- and community-based services waivers and PACE programs can pay for care at home or in the community for people who would otherwise qualify for a nursing home.

Common questions

What's the difference between a skilled nursing facility and a nursing home for Medicare purposes?

They can be the same building, but Medicare pays based on the type of care, not the address. A stay counts as covered skilled care only if you need daily skilled nursing or therapy tied to a recent hospitalization; the same facility providing long-term custodial help with bathing, dressing, and eating is not covered. Many people are surprised that a Medicare-certified SNF stay and a permanent nursing home stay can happen in the same place with completely different coverage.

What do I actually pay during the 100 days of covered skilled nursing care?

For a qualifying SNF stay, Medicare covers days 1 through 20 at $0 per day after you've paid the Part A deductible (you don't pay it again if you already paid it for a hospital stay in the same benefit period). Days 21 through 100 carry a daily coinsurance ($217 per day in 2026), and after day 100 you pay all costs. A Medigap policy or Medicare Advantage plan may cover some or all of the day 21–100 coinsurance.

Once Medicare stops paying, how do people cover a long-term nursing home stay?

The three common routes are paying out of pocket, using a long-term care insurance policy bought earlier, or qualifying for Medicaid. Medicaid can cover long-term nursing home care, but you must meet your state's income and asset limits, which often means spending down savings first. Rules vary significantly by state.

What happens if I improve and then decline again — can the 100 days reset?

Medicare limits SNF coverage to 100 days in each benefit period, and the benefit is tied to a benefit period rather than a calendar year. A new benefit period with a fresh set of days can begin after a break in care — check Medicare.gov or call 1-800-MEDICARE for the exact rules on when a new benefit period starts, as the specifics can be confusing.

Does Medicare cover any long-term care in the home instead of a nursing home?

Medicare can cover limited home health care — intermittent skilled nursing or therapy for people who are homebound — but it does not pay for around-the-clock custodial care at home any more than it does in a facility. It won't cover a home aide whose only job is helping with daily living. That ongoing personal-care support falls into the same coverage gap as long-term nursing home care.

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