Does Medicare Pay for Nursing Home Care?

Medicare Part A covers up to 100 days of skilled nursing per benefit period after a hospital stay, but not long-term custodial care. Learn the rules.

Category: costs-and-payment · Updated 2026

Medicare pays for some nursing home care, but far less than many families expect. It covers a short-term skilled nursing facility stay under Part A when the clinical and hospitalization conditions are met. It does not pay for long-term care that is mainly help with daily activities, which is what most people mean by living in a nursing home. Understanding the line between skilled care and custodial care prevents surprises.

This guide explains the Medicare skilled nursing facility benefit, the days it covers, the hospital requirement, and what to do when coverage ends.

What Medicare Part A covers

Medicare Part A helps pay for care in a Medicare-certified skilled nursing facility for up to 100 days per benefit period when all of these are true:

There was a qualifying inpatient hospital stay, generally at least 3 consecutive days, not counting the discharge day
The person was admitted for a condition related 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 check the plan.

Days, cost sharing, and benefit periods

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

A benefit period ends when the person has been out of the facility for 60 consecutive days. Then a new benefit period can start if the person qualifies again.

What Medicare does not cover

Medicare does not cover long-term custodial care, such as help with bathing, dressing, and meals when that is the main need. It also does not provide lifetime nursing home coverage. If a person's medical need drops below the skilled level and only custodial care remains, Medicare coverage ends even if the 100 days are not used up. At that point families consider Medicaid, long-term care insurance, VA benefits, or private pay.

The difference between skilled and custodial care

Skilled care is care that must be provided by licensed nurses or therapists, such as wound care, IV therapy, injections, or active rehabilitation. Custodial care is help with daily living and supervision that can be provided by aides. 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 when only custodial care remains.

What to do when Medicare coverage ends

Plan ahead before the covered days run out:

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 reset with a new hospital stay?

The 100 days are 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 within that window, the same benefit period and day count continue.

Can Medicare Advantage cover 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 says 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.

Does Medicare pay for 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.

Does Medicare pay for 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 informational and is not medical advice. Processing date: 2026-10-05.

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