Medicare can help pay for some stays in a nursing home but only under strict conditions. Original Medicare usually does not cover long term nursing home care where a person resides primarily for daily living and personal assistance.
However, in specific cases, Medicare Part A (hospital insurance) will pay for short‑term skilled nursing facility (SNF) care after a qualifying hospital stay.
Understanding what Medicare will pay in 2026 and who is eligible can help you plan care and costs accurately.
What kind of nursing home care does Medicare cover?
Medicare differentiates between custodial care and skilled nursing care. Custodial care includes help with daily activities like bathing, dressing, eating, and toileting. Medicare does not cover custodial care in a nursing home if this is the only care needed.
Calculate Your 2026 COLA Increase →Medicare Part A may cover skilled nursing care in a certified nursing facility (SNF) under strict conditions. Skilled care includes nursing or therapy services that must be performed by or under professional supervision to treat or manage a medical condition.
What is a qualified stay under Medicare Part A?
To qualify for Medicare to pay for a nursing home stay, the services must meet specific eligibility criteria:
- You must have Medicare Part A and have days left in your benefit period.
- You must first have a qualifying inpatient hospital stay of at least 3 days in a row. Time spent in hospital observation or in the emergency room does not count.
- You must enter the skilled nursing facility within a short time (generally 30 days) after leaving the hospital.
- Your doctor must certify that you need daily skilled nursing or therapy care that can only be given in a skilled setting.
- The care must be for a condition treated during the qualifying hospital stay or a condition that began while you were in the SNF receiving covered care.
If these conditions are not met, Medicare will not pay for the nursing home stay.
How long will Medicare pay for nursing home care?
When Medicare Part A covers skilled nursing facility care, there are limits on how many days will be paid in a benefit period:
- Days 1–20: Medicare pays 100 percent of the costs for covered services.
- Days 21–100: You pay a daily coinsurance amount in 2026 after the Part A deductible is met.
- Days 101 and beyond: Medicare generally pays nothing for additional days in that benefit period.
A benefit period ends when you have not received inpatient hospital or SNF care for 60 days in a row. If you start a new benefit period later, you may need to pay the Part A deductible again.
What costs will I pay under Medicare?
In 2026, the Part A deductible is $1,736 per benefit period.
- For the first 20 days of SNF care, Medicare covers the full cost after the deductible is satisfied.
- From days 21 to 100, you pay a daily coinsurance amount (in 2026 this is about $217 per day).
- After 100 days, Medicare does not pay for the SNF stay, and you are responsible for all costs.
These amounts apply to Original Medicare. If you have a Medicare Advantage plan (Part C), coverage and costs might be different, so it is important to check with your plan.
Are long‑term nursing home costs covered by Medicare?
Medicare does not cover long‑term nursing home care if the primary reason for the stay is custodial care or assistance with daily activities.
This type of care includes help with eating, dressing, bathing, and toileting and is the main cost for most long‑term nursing home residents.
Medicare Coverage rules state that long‑term care services are not covered and you would have to pay out of pocket or rely on other programs.
Can Medicare Part B help pay nursing home costs?
Medicare Part B (medical insurance) does not cover routine nursing home care or SNF stay costs. It mainly covers outpatient services like doctor visits and preventive care.
Part B may cover some outpatient therapy or medical services you receive while in a nursing home, but it does not pay facility costs.
What are my options if Medicare will not pay?
If Medicare will not pay for long‑term nursing home care, alternatives include:
- Medicaid: A joint federal‑state program that covers long‑term care for people with low income and limited assets. Eligibility and benefits vary by state.
- Private long‑term care insurance: Policies you buy before needing care to help pay for daily living support in a nursing facility or at home.
- Personal savings and assets: Many people pay for custodial care out of pocket.
Does Medicare Advantage cover nursing home care?
Medicare Advantage (Part C) plans offered by private insurers must cover everything Original Medicare covers, including covered skilled nursing stays.
Some plans may offer additional benefits, but coverage varies by plan. Contact your plan provider or review plan documents for details.
