Will Medicare Cover Nursing Home Care?

Medicare Part A covers as many as 100 days of skilled nursing per benefit period after a hospital stay, but never long-term custodial care. Learn the rules.

Updated 2026

This guide is informational and is not medical advice.

Category: costs-and-payment · Updated 2026

Medicare does pay for some nursing home care, though far less than most families anticipate. Under Part A it covers a short-term skilled nursing facility stay when the clinical and hospitalization conditions are satisfied. It does not pay for long-term care that amounts mainly to help with daily activities, which is what most people picture when they imagine living in a nursing home. Grasping the boundary between skilled care and custodial care prevents nasty surprises.

This guide spells out the Medicare skilled nursing facility benefit, the days it covers, the hospital requirement, and what to do once coverage lapses.

What Part A pays for

Medicare Part A helps cover care in a Medicare-certified skilled nursing facility for up to 100 days per benefit period when all of the following hold:

The person had a qualifying inpatient hospital stay, generally at least 3 consecutive days, not counting the discharge day
The person was admitted for a condition connected to the hospital stay
Skilled nursing or therapy is medically necessary
The facility is Medicare-certified

Medicare.gov publishes the details at Skilled Nursing Facility Care. Medicare Advantage plans may waive the 3-day inpatient rule, so verify the plan.

Days, cost sharing, and benefit periods

Days in the benefit period	What you pay
Days 1 to 20	Medicare covers the services; no daily coinsurance for the stay
Days 21 to 100	A daily coinsurance amount set annually; check Medicare.gov for the current figure
After day 100	Medicare coverage stops; other payers or private funds take over

A benefit period ends after the person has gone 60 consecutive days without facility care. A new benefit period can then begin if the person qualifies again.

What Medicare will not cover

Medicare does not cover long-term custodial care, such as help with bathing, dressing, and meals when that is the primary need. Nor does it provide lifetime nursing home coverage. If a person's medical need falls below the skilled level and only custodial care remains, Medicare coverage ends even if the 100 days have not been exhausted. At that point families look to Medicaid, long-term care insurance, VA benefits, or private pay.

Skilled care versus custodial care

Skilled care must be furnished by licensed nurses or therapists, for example wound care, IV therapy, injections, or active rehabilitation. Custodial care is help with daily living and supervision that aides can provide. Medicare pays for skilled care when it is medically necessary; it generally does not pay for custodial care. The same resident can move between the two, and coverage can stop once only custodial care remains.

Steps for when Medicare coverage ends

Prepare before the covered days expire:

Ask the facility and a discharge planner for a written notice when coverage is ending
Request a Medicare determination review if you disagree with the decision
Check whether the person qualifies for Medicaid in this state, which may require a spend-down
Check VA benefits if the person is a veteran or surviving spouse
File a long-term care insurance claim if a policy exists
Ask the facility whether it will keep a Medicaid-eligible resident once private funds run out

Read Medicaid and Nursing Home Coverage for the next step.

Sources: Medicare.gov skilled nursing facility care; Medicare.gov home health; CMS Medicare coverage.

Related guides

Frequently asked questions

Do the 100 days start over after a new hospital stay?

The 100 days apply per benefit period, not per hospital stay. A benefit period ends after 60 consecutive days without skilled care. If the person returns to the hospital and then to skilled care inside that window, the same benefit period and day count continue.

Might Medicare Advantage pay for more days?

Medicare Advantage plans must cover at least what Original Medicare covers and may offer more, such as waiving the 3-day hospital requirement. Check the specific plan's evidence of coverage.

What if the facility notifies us that Medicare will stop paying?

You receive a notice, and you can request a fast review from Medicare if you believe the decision is wrong. Do it promptly, because the review has short deadlines. A discharge planner or the state's Senior Health Insurance Assistance Program can help.

Will Medicare cover assisted living?

Generally no. Medicare does not cover room and board or custodial care in assisted living. It may cover some medical services separately. Long-term assisted living costs are usually private pay or covered through a Medicaid waiver for those who qualify.

Will Medicare cover memory care?

Medicare does not cover long-term memory care or custodial care. It can cover skilled nursing or therapy in a nursing home after a qualifying hospital stay. Long-term memory care is usually private pay or Medicaid through a state waiver.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is provided for information and is not medical advice. Processing date: 2026-10-06.

Required disclosures

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