Question 1

Does Medicare cover nursing home care?

Accepted Answer

Medicare covers short-term skilled nursing facility (SNF) care only after a qualifying 3-day hospital stay. Medicare pays 100% for days 1-20, then you pay a daily coinsurance ($209.50/day in 2026) for days 21-100. After day 100, Medicare pays nothing. Medicare does not cover custodial nursing home care (help with daily activities like bathing and dressing).

Question 2

Does Medicare cover assisted living?

Accepted Answer

No. Medicare does not cover assisted living facility costs. Assisted living is considered custodial care, which Medicare explicitly excludes. You would need to pay out of pocket, use long-term care insurance, or qualify for Medicaid to cover assisted living costs.

Question 3

Does Medicare cover home health care?

Accepted Answer

Medicare covers medically necessary skilled home health care if you are homebound and your doctor certifies a need for skilled nursing or therapy services. Covered services include skilled nursing visits, physical therapy, occupational therapy, and speech therapy. Medicare does not cover 24-hour home care, meal delivery, or homemaker services.

Question 4

What is the difference between skilled care and custodial care?

Accepted Answer

Skilled care requires the services of a licensed professional such as a nurse, physical therapist, or occupational therapist and is medically necessary for treatment or recovery. Custodial care (also called personal care) involves assistance with daily activities such as bathing, dressing, eating, and using the bathroom. Medicare covers skilled care but not custodial care.

Question 5

How do people pay for long-term care if Medicare does not cover it?

Accepted Answer

The main options for paying for long-term care are: personal savings and assets, long-term care insurance, hybrid life insurance/annuity products with long-term care riders, Medicaid (for those who meet income and asset limits), and Veterans benefits (for eligible veterans). A financial planner or Medicare specialist can help you evaluate your options.

Question 6

Does Medicare Advantage cover more long-term care than Original Medicare?

Accepted Answer

Medicare Advantage plans must cover everything Original Medicare covers, including the same skilled nursing facility benefit. Some Medicare Advantage plans offer additional home health or personal care benefits beyond Original Medicare, but comprehensive custodial long-term care coverage is not a standard Medicare Advantage benefit.

Service	Coverage	Details
Skilled Nursing Facility (Days 1-20)	Medicare Covers	Medicare pays 100% after a qualifying 3-day hospital inpatient stay. Must require skilled nursing or therapy services.
Skilled Nursing Facility (Days 21-100)	Limited Coverage	You pay $209.50/day coinsurance in 2026. Medicare pays the remainder. Coverage ends at day 100.
Skilled Nursing Facility (Day 101+)	Not Covered	Medicare pays nothing after day 100. You are responsible for the full daily cost, which averages $300-$400/day.
Skilled Home Health Care	Medicare Covers	Covered if you are homebound and need skilled nursing, physical therapy, occupational therapy, or speech therapy. No prior hospital stay required.
Custodial Home Care (Help with Daily Activities)	Not Covered	Medicare does not cover non-skilled help with bathing, dressing, eating, or other daily activities, even if provided at home.
Assisted Living Facility	Not Covered	Medicare does not cover assisted living costs. This is considered custodial care and is explicitly excluded from Medicare coverage.
Memory Care / Dementia Care	Not Covered	Medicare does not cover room and board in memory care facilities. Medicare may cover some medically necessary services (physician visits, medications) within a facility.
Adult Day Services	Not Covered	Medicare does not cover adult day services programs. Some Medicare Advantage plans may offer limited adult day benefits as an extra benefit.
Hospice Care	Medicare Covers	Medicare covers hospice care for terminal illness with a life expectancy of 6 months or less. Includes nursing, medications, counseling, and respite care.
Home Health Aide (Skilled Care Context)	Limited Coverage	Medicare covers part-time home health aide services only when you are also receiving skilled nursing or therapy services. Standalone home health aide services are not covered.

Days in SNF	Medicare Pays	You Pay	Note
Days 1-20	100%	$0	Requires qualifying 3-day hospital stay
Days 21-100	All but $209.50/day	$209.50/day	2026 coinsurance amount
Day 101+	$0	100% of cost	Average $300-$400/day

Does Medicare Cover Long-Term Care?

Skilled Care vs. Custodial Care: The Critical Distinction

Skilled Care — Medicare Covers

Custodial Care — Medicare Does NOT Cover

What Medicare Covers (and Does Not Cover)

Skilled Nursing Facility Costs in 2026

How People Pay for Long-Term Care

Personal Savings

Long-Term Care Insurance

Hybrid Life/LTC Policies

Medicaid

Veterans Benefits

Medicare Savings Programs

Florida Medicaid and Long-Term Care

Plan Ahead for Long-Term Care Costs

Frequently Asked Questions