Does Medicare Cover Nursing Home Bills?

Many seniors and their families assume that Medicare will pay for the costs of a nursing home stay when long-term care becomes necessary.

Unfortunately, that’s not always the case. Medicare only offers limited coverage for skilled nursing care, and many people are surprised to learn they’ll need to explore other options for ongoing care. Let’s dive into what Medicare does—and doesn’t—cover, and what you can do to prepare.

Understanding Medicare’s Nursing Home Coverage

Medicare is a federal health insurance program for individuals aged 65 and older, as well as certain younger individuals with disabilities. It’s designed to help cover medical expenses, but it doesn’t function as a long-term care solution.

To be more specific, Medicare Part A (inpatient hospital stays and nursing care fall under the umbrella of Medicare Part A) will cover up to 100 days in a skilled nursing facility (SNF), but only after a qualifying 3-day hospital stay and only if daily skilled care is medically necessary.

Also, even if you meet the above requirements, Medicare won’t cover the costs indefinitely. Instead, they offer the following payment plan:

• Days 1–20: Medicare pays in full.
  
• Days 21–100: You’re responsible for a daily skilled nursing facility coinsurance fee ($209.50/day in 2025).
  
• After day 100: Medicare stops paying entirely.

Generally, Medicare coverage is meant for rehabilitation or recovery, not long-term custodial care. If you or a loved one needs help with daily activities like bathing, eating, or dressing beyond the initial 100 days, you’ll need to look elsewhere for financial assistance.

Read More: Medicare vs Medicaid: Paying for Long-Term Care

What About Assisted Living or Personal Care?

Medicare does not cover expenses associated with assisted living facilities, long-term stays in nursing homes, custodial care, or personal care not tied to medical rehabilitation. In other words, families must find other funding sources—like private pay, long-term care insurance, or Medicaid—for extended nursing home care.

Read More: How Can an Attorney Help with Long-Term Care?

Medicare vs. Medicaid

When Medicare isn’t enough, Medicaid becomes a vital resource. Medicaid does cover long-term nursing home care, but eligibility is based on strict income and asset limits. To qualify, many individuals must first “spend down” their assets or implement smart financial strategies to protect them.

Common tools include:

• Medicaid Compliant Annuities: Convert excess assets into income to meet Medicaid’s asset threshold.
  
• Irrevocable Trusts: Transfer ownership of certain assets to preserve them from Medicaid estate recovery at least five years prior to requiring benefits.
  
• Spousal Protections: Transfer allowable assets to the healthy spouse to avoid unnecessary financial strain.
  
• Personal Care Agreements: Legally pay family caregivers to offset the burden of care. 

In short, the answer to the question “Does Medicare cover nursing home bills?” is, unfortunately, no. But the good news is, you still have tools to ensure that you and your loved ones receive the care they need. 

Take the Next Step

Now that you understand the limitations of Medicare and the importance of planning ahead, you can take control of your long-term care journey.

Tell us about your situation, and let’s explore your options.