Key takeaways:
Medicare Part A covers skilled care services in a nursing home for up to 100 days per benefit period. However, Medicare does not cover long-term care in a nursing home.
To qualify for skilled care coverage under Medicare, you must meet certain requirements, including having a 3-day inpatient hospital stay and receiving services in a Medicare-certified facility.
The number of days you receive skilled care services in a facility determines how much Medicare will pay.
The idea of moving into a nursing home can be overwhelming, even before you start thinking about how to pay for the costs. But it’s helpful to know in advance what insurers, like Medicare, will cover.
Nursing homes offer two types of care: skilled and long term. Skilled care is medical care provided by licensed professionals to treat health conditions. Facilities that provide this kind of care are called skilled nursing facilities (SNFs). Long-term, or custodial care focuses on assistance with activities of daily living, such as bathing, dressing, and eating, and is not always performed by licensed professionals.
Original Medicare does not cover long-term nursing home care, but it offers limited coverage for skilled care services in an SNF.
How much does a nursing home cost?
On average, nursing homes can cost between $9,000 and nearly $11,000 per month. But the costs can be much more or less, depending on where you live. For example, you can expect to pay about $15,000 a month to stay in a nursing home in New York state. That’s more than twice the cost of a nursing home in Texas, which averages approximately $6,200 per month.
Other factors that impact the cost of a nursing home include:
Type of room
Quality of care
Length of stay
Extra medical care or services received
Does Medicare cover nursing home costs?
Medicare Part A may help cover nursing home costs, but only for short-term skilled care. Part A may cover this type of care if you’re recovering from an illness, injury, or surgery and receiving the care in a skilled nursing facility, or SNF, from licensed professionals. You must meet certain criteria (which we cover below) to qualify for coverage.
Medicare does not cover long-term care services. If you need to stay in a nursing home to receive help with activities of daily living — such as bathing, dressing, and eating — or have a chronic condition that requires ongoing care, Medicare generally will not cover those costs. In this case, you may need to consider other options, such as Medicaid, long-term care insurance, or commercial insurance.
How do the different parts of Medicare cover nursing homes?
Here's a breakdown of how each part of Medicare handles nursing home coverage:
Medicare Part A: Part A generally covers hospital stays, SNF care, hospice care, and some home health services. However, Part A does not cover long-term stays in nursing homes.
Medicare Part B: Part B primarily covers outpatient medical services, like medical office visits. It does not cover nursing home care. But if you’ve reached your 100-day limit for SNF coverage in a benefit period, Medicare Part B may continue to cover skilled therapy services while you’re in the facility.
Medicare Part C: Also referred to as Medicare Advantage, Part C offers a way to get your Medicare benefits through a commercial insurance company. Some Medicare Advantage plans include coverage for SNF stays and long-term care in nursing homes.
Medicare Part D: While Part D does not cover nursing home care, it may cover prescription medications needed as part of a nursing home stay.
How much does a nursing home cost? Prices for nursing homes vary widely, but these key factors can help you plan ahead.
Medicare covers some dementia-related services, but not long-term care. We break down which dementia-related treatments qualify for Medicare coverage and what costs to expect.
Medicare doesn’t cover custodial care in an assisted living facility. But it may still pay for medical services you receive while living there.
What services does Medicare cover in a nursing home?
Medicare generally covers the following services and items provided in an SNF:
A semiprivate room shared with other nursing home residents
Meals and counseling
Medical care from licensed healthcare professionals
Physical therapy to help improve strength, mobility, and overall physical function
Occupational therapy to help you perform daily activities independently and safely
Speech-language pathology services that help with communication, swallowing, and other related functions
Support from professional social workers
Prescription medications
Necessary medical supplies and equipment
Ambulance transportation to another facility if it’s unsafe for you to travel any other way, and the SNF doesn’t offer the service you need
Ultimately, the services you receive in an SNF will depend on your needs and the treatment plan developed by your healthcare professionals.
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How do you qualify for nursing home coverage under Medicare?
To be eligible for SNF coverage under Medicare, you must meet the following conditions:
You must have Medicare Part A coverage and have days remaining in your benefit period.
You must have had a qualifying hospital stay — meaning, you were admitted as an inpatient for at least 3 days in a row before transferring to the SNF.
You must have entered the SNF within 30 days of leaving the hospital.
A healthcare professional must determine that you need daily skilled care, which must be provided by trained nursing or therapy staff.
The SNF must be certified by Medicare. You can search and compare Medicare-certified nursing homes in your area using Medicare’s online comparison tool.
The skilled care you receive must be for a health condition that was either treated during your hospital stay or began while you were getting SNF care for a hospital-related condition. For example, if you’re admitted to an SNF to recover from hip surgery and develop an infection that requires IV antibiotics during your stay, Medicare may cover both the rehabilitation and the treatment for the infection.
How long does Medicare pay for nursing home care?
Medicare covers skilled care in a nursing home for up to 100 days per benefit period, as long as you meet certain requirements.
A benefit period starts the day you’re admitted for inpatient hospital or SNF care. It ends when you’ve either:
Gone 60 days in a row without needing inpatient hospital or skilled nursing care
Used all 100 days of covered SNF care in that benefit period
After a benefit period ends, Medicare coverage for skilled nursing care resets for up to 100 days, but only if you qualify again. That means you’ll need to have a new 3-day inpatient hospital stay and meet all other Medicare requirements. Medicare does not limit the number of benefit periods you can have as long as you meet the criteria.
Say you’re admitted to a hospital for hip replacement surgery, stay for 3 days, and then transfer to an SNF for rehabilitation. Then, you receive 14 days of Medicare-covered skilled care before being discharged home. If you return to the SNF within 30 days because you need additional physical therapy for your hip, you won’t need another hospital stay. Your benefit period will continue, and you’ll still have 86 days of SNF coverage left. But if you’re out of the hospital and SNF for 60 days in a row, your benefit period will end.
If you’re once again hospitalized for at least 3 days and need care at an SNF, Medicare will start a new benefit period, and you may be eligible for up to another 100 days of coverage.
The length of time you receive skilled care services in an SNF affects how much Medicare will pay. The table below shows the amount Medicare pays and your potential out-of-pocket costs for different lengths of stay.
Length of stay in a skilled nursing facility | Medicare Part A coverage | Your out-of-pocket costs |
Days 1-20 | Full | $0 |
Days 21-100 | Partial | You’re responsible for a coinsurance of up to $209.50 daily. |
Day 101 and beyond | None | You’re responsible for all of the costs. |
For the first 20 days of a benefit period, Medicare Part A covers the full cost of skilled care given in an SNF. Starting on Day 21, you may be responsible for up to $209.50 per day in coinsurance. If Medicare is your only insurance and you receive covered SNF care for the full 100 days, your out-of-pocket costs could total nearly $17,000.
After Day 100, Medicare stops paying, so you would be responsible for all costs for the rest of the benefit period. If you qualify for a new benefit period later on, Medicare coverage would restart with the same payment structure and cost-sharing expectations.
Does Medicare supplement insurance help cover nursing home costs?
Medicare supplement insurance (Medigap) policies generally do not provide coverage for long-term care in nursing homes. However, most Medigap plans cover the costs of coinsurance for SNF stays. Out of the ten available Medigap plans, only Plan A and Plan B don’t cover SNF-related expenses. Plans C, D, F, G, K, L, M, and N cover some portion of SNF coinsurance costs.
The amount of SNF coinsurance costs covered varies by Medigap plan. Plan K covers 50% of the coinsurance costs that kick in after Day 20 at an SNF, while Plan L covers 75% of these costs.
When selecting Medigap coverage, carefully review each plan's benefits to decide which best suits your needs.
How does Medicare Advantage coverage compare?
Medicare Advantage plans offer the same level of SNF coverage as original Medicare. However, the rules and cost-sharing amounts may vary depending on the plan. Some Medicare Advantage plans cover long-term (custodial) care as an optional benefit that typically requires an additional premium.
Frequently asked questions
Medicare doesn’t cover room and board or custodial care, like help with bathing or dressing, received in an assisted living facility. But Medicare may cover certain medical services, like healthcare professional visits and physical therapy, or medical equipment while you’re in the facility. If you need help paying for assisted living, consider long-term care insurance or Medicaid, if you qualify.
Similar to skilled nursing facility coverage, Medicare may cover a short stay in a convalescent home if you receive skilled nursing care and meet certain requirements. (A convalescent home is another term for a facility that helps people recover after a hospital stay.) But if you only need help with activities of daily living, like dressing or bathing, Medicare won’t provide coverage.
Medicare doesn’t pay for long-term nursing home care, even for people with dementia. It may cover short-term skilled nursing care after a hospital stay if you meet certain requirements, but it won’t cover help with daily activities or memory-related care in a nursing home. However, Medicare covers some parts of dementia care.
Medicare may cover short-term nursing home care if you have cancer and need skilled medical care, as long as you meet the requirements. For example, after a qualifying hospital stay, Medicare may cover services like IV medications, wound care, or pain management provided in a nursing home. But Medicare won’t cover long-term custodial nursing home care, even for people with cancer.
Medicare Part A pays the nursing home directly for covered skilled care services. For the first 20 days, Medicare covers the full cost. From Days 21 to 100, you’ll pay a daily coinsurance. After Day 100, Medicare stops paying, so you’ll be responsible for all costs. This payment cycle starts over with each new benefit period you qualify for.
Medicare doesn’t cover room and board or custodial care, like help with bathing or dressing, received in an assisted living facility. But Medicare may cover certain medical services, like healthcare professional visits and physical therapy, or medical equipment while you’re in the facility. If you need help paying for assisted living, consider long-term care insurance or Medicaid, if you qualify.
Similar to skilled nursing facility coverage, Medicare may cover a short stay in a convalescent home if you receive skilled nursing care and meet certain requirements. (A convalescent home is another term for a facility that helps people recover after a hospital stay.) But if you only need help with activities of daily living, like dressing or bathing, Medicare won’t provide coverage.
Medicare doesn’t pay for long-term nursing home care, even for people with dementia. It may cover short-term skilled nursing care after a hospital stay if you meet certain requirements, but it won’t cover help with daily activities or memory-related care in a nursing home. However, Medicare covers some parts of dementia care.
Medicare may cover short-term nursing home care if you have cancer and need skilled medical care, as long as you meet the requirements. For example, after a qualifying hospital stay, Medicare may cover services like IV medications, wound care, or pain management provided in a nursing home. But Medicare won’t cover long-term custodial nursing home care, even for people with cancer.
Medicare Part A pays the nursing home directly for covered skilled care services. For the first 20 days, Medicare covers the full cost. From Days 21 to 100, you’ll pay a daily coinsurance. After Day 100, Medicare stops paying, so you’ll be responsible for all costs. This payment cycle starts over with each new benefit period you qualify for.
The bottom line
Medicare Part A covers up to 100 days of skilled care services in a nursing home per benefit period. Facilities that provide this kind of care are called skilled nursing facilities (SNFs). However, Medicare doesn't pay for long-term care. You may want to consider options like Medicaid or commerical insurance if you anticipate needing this type of care.
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References
American Speech-Language-Hearing Association. (n.d.). Who are speech-language pathologists, and what do they do?
CareScout. (n.d.). Calculate the cost of long-term care near you.
Centers for Medicare & Medicaid Services. (2024). Items and services not covered under Medicare.
Medicare.gov. (n.d.). Compare Medigap plan benefits.
Medicare.gov. (n.d.). Find and compare providers near you.
Medicare.gov. (n.d.). Long-term care.
Medicare.gov. (n.d.). Nursing home care.
Medicare.gov. (2025). Medicare coverage of skilled nursing facility care.
National Cancer Institute. (n.d.). ADL. National Institutes of Health.
National Institute on Aging. (2023). Paying for long-term care. National Institutes of Health.
