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Does Medicare Cover Nursing Homes? Explore Coverage Options and Eligibility

7 minute readLast updated July 11, 2024
Written by Claire Samuels
fact checkedby
Danny Szlauderbach
Reviewed by Letha McDowell, CELA, CAPCertified Elder Law Attorney Letha Sgritta McDowell is a past president of the National Academy of Elder Law Attorneys.
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Medicare will cover nursing home costs for your loved one if they meet Medicare’s qualifications, like being an inpatient at a hospital and having a doctor’s order for post-hospital nursing care. Medicare (Part A) can also cover short-term nursing care for rehabilitative needs. Medicare won’t cover long-term nursing home stays if custodial care is all that’s needed. Below, we’ll detail the qualifications for Medicare coverage and explore different plan types that cover skilled nursing home stays.

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Key Takeaways

  1. Medicare nursing home coverage kicks in after a three-day inpatient hospital stay, but days of “observation” don’t count, and post-hospital nursing care must be doctor-ordered.
  2. Medicare may pay in full for days 1-20 and partially for days 21-100, at which point it will no longer pay for skilled nursing home care.
  3. After day 100, medical care costs are still covered, like certain supplies, devices, and other aspects of medical care.
  4. Medicare Part A covers short-term nursing home stays, but Advantage plans may offer more coverage.

Medicare Part A and nursing homes

Medicare Part A, also called Hospital Insurance, can cover certain short-term stays in nursing homes or skilled nursing facilities to recover from illness, injury, or surgery. A senior must meet several criteria for Medicare Part A as well as Medicare’s nursing home criteria. To be covered under Part A Hospital Insurance, stays must be considered rehabilitative after a hospital visit and prescribed by a doctor.

How does a senior qualify for Medicare nursing home coverage?

For Medicare to pay for a short-term nursing home stay, a senior must meet the following requirements:

  • Have Medicare Part A. When a person signs up for Medicare, Hospital Insurance is automatically included, unless they request otherwise.
  • Choose a Medicare-certified nursing home. Not all nursing homes are certified by Medicare. Some private facilities, for example, may choose to only accept patients who can pay out of pocket.
  • Have been discharged from a three-day or longer inpatient hospital stay. Not all hospital stays qualify. When your loved one is checked in at the hospital, ask if they’re being admitted or if they’re only there for observation. Even if they stay overnight, a period of observation doesn’t qualify for a Medicare-covered nursing home stay. Only after you’ve been admitted to the hospital as an “inpatient” by a doctor’s order will you qualify.[01]
  • Have a doctor’s order for skilled nursing care post-hospital stay. For Medicare to pay, your loved one’s physician or emergency room doctor must prescribe a rehabilitative stay in a nursing home or skilled nursing facility.
  • Require care related to a specific medical condition. This can be either the condition treated during the qualifying hospital stay or a separate health concern that began during their nursing home stay.
  • Be admitted to the nursing home within 30 days of leaving the hospital. Generally, your loved one’s doctor will recommend a facility for them to move into after the hospital stay. Keep in mind that there may be waiting lists.
  • Need daily skilled nursing care. If your loved one needs assistance with ADLs like dressing and bathing, but doesn’t require medical care from a skilled nursing or therapy staff, they won’t qualify for a nursing home stay funded by Medicare.[02]
  • Accept a semi-private room. Medicare doesn’t cover private rooms in nursing homes, except when medically necessary.

How long does Medicare pay for nursing home care?

Medicare Part A will fully cover a senior’s rehabilitative stay in a nursing home for up to 20 days, and partially from days 21-100. Medicare stops covering custodial costs after 100 days but will cover skilled or medical care services thereafter. This period is intended to help an individual recuperate after a hospital stay.

How much does Medicare pay for a nursing home?

Medicare Part A covers 100% of the costs for the first 20 days in a nursing home. On day 20, your loved one may have to pay up to $204 a day in coinsurance costs.[04] Coverage of nursing home care stops after day 100.[03] If your loved one needs to be in the nursing home longer, your family may have to rely on other resources to pay for care, like long-term care insurance.

Consider that a semi-private room in a nursing home has a median monthly cost of $7,800 in the U.S.[05] So, even if your loved one has to pay the maximum of $204 in coinsurance for 80 days, they’ll be paying $16,320 for a full 100-day stay, instead of over $24,000.

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Medicare Advantage plans and nursing home care

Medicare Advantage — also called Medicare Part C — plans can be purchased through private companies based on where your loved one lives. These plans generally accompany Medicare Parts A and B, but provide additional services, such as nonemergency hearing, vision, and dental care.[07]

If your loved one has a Medicare Advantage plan, they also have Hospital Insurance, as described above, so they’ll receive rehabilitative treatment in a nursing home covered by Medicare. After their benefit period ends, Advantage plans will cover some of the costs of medical care in a nursing home or skilled nursing facility, but they won’t cover custodial care, help with activities of daily living (ADLs), or monthly rent.

Keep in mind that Medicare Advantage plans may have different rules regarding coinsurance. Some families may find that even the first 20 days of nursing home care aren’t fully covered, and they could have coinsurance expenses beyond $200 a day throughout their stay.

Because of a change made in 2019, some Medicare Advantage plans may cover individual personal care services. These select few plans cover services with a “functional impact on health issues” and are designed to reduce the need for emergency services down the road.[07]

Medicare Long-Term Stay Coverage: Inclusions and Exclusions

Care provided in nursing homes can be broken down into two categories: custodial care and skilled nursing care. Original Medicare pays for skilled care services, but not custodial care, during long-term nursing home care.[02]

  • Custodial care includes assistance with activities of daily living (ADLs) including dressing, bathing, and using the toilet. Because this type of personal care is nonmedical, it can be provided by care aides and doesn’t require a nurse or doctor.
  • Skilled care, or skilled nursing care, requires the provider to have a degree or certification. Skilled care generally includes wound care, injections, medication administration, and physical therapy.

What does Medicare cover in long-term nursing home care?

Your loved one’s Medicare benefits can cover some long-term care services offered in nursing homes. Medicare-covered long-term care services include the skilled care services mentioned above, along with:

  • Medical devices like wheelchairs, oxygen, and walkers
  • Medical supplies, such as bandages, sharps, or incontinence supplies
  • Physical, occupational, or speech therapy
  • Part-time or intermittent skilled nursing for an acute condition
  • Medical social services to cope with side effects of a chronic illness

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How to find Medicare-covered nursing homes near you

If your loved one needs a short-term rehabilitative stay in a skilled nursing facility or nursing home, their doctor will likely provide information and recommendations when they prescribe the stay.

However, if your relative needs help aging safely and would benefit from senior living, there are multiple potential options to pursue. While nursing homes offer the highest level of medical care, assisted living communities can also offer safe, supportive residential environments for aging adults to call home.

Reach out to one of A Place for Mom’s Senior Living Advisors to discuss senior living options near you, set up tours, and work through your budget — all at no cost to your family.

SHARE THE ARTICLE

  1. Centers for Medicare and Medicaid Services. Inpatient hospital care.

  2. Centers for Medicare and Medicaid Services. Nursing home care.

  3. Medicare Interactive. SNF care past 100 days.

  4. Centers for Medicare and Medicaid Services. (2022, December). Medicare coverage of skilled nursing facility care.

  5. Genworth. (2022, February 7). Cost of Care trends and insights.

  6. Department of Health and Human Services. (2015, April). What’s a Medicare Advantage plan?

  7. Sung, J.E., and Noel-Miller, C. (2018, October 30). Supplemental benefits in Medicare Advantage: What’s changing in 2019 and what’s not. AARP Public Policy Institute.

Written by
Claire Samuels
Claire Samuels is a former senior copywriter at A Place for Mom, where she helped guide families through the dementia and memory care journey. Before transitioning to writing, she gained industry insight as an account executive for senior living communities across the Midwest. She holds a degree from Davidson College.
Fact checked by
Danny Szlauderbach
Danny Szlauderbach is a video producer and former Managing Editor at A Place for Mom, where he's written or reviewed hundreds of articles covering a wide range of senior living topics, from veterans benefits and home health services to innovations in memory care. Since 2010, his editing work has spanned several industries, including education, technology, and financial services. He’s a member of ACES: The Society for Editing and earned a degree in journalism from the University of Kansas.
Certified Elder Law Attorney Letha Sgritta McDowell is an elder law attorney and past president of the National Academy of Elder Law Attorneys.
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