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Does Medicare Cover Nursing Homes?

7 minute readLast updated July 3, 2025
Written by Claire Samuels
fact checkedby
Tori Newhouse
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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Yes, Medicare Part A may partially cover up to 100 days in a nursing home if skilled nursing care is required. Medicare won’t cover stays longer than 100 days, and it won’t cover a nursing home stay at all if skilled nursing care isn’t needed. Medicare Part B covers outpatient expenses and won’t cover a nursing home stay. Privately purchased Medicare Advantage plans (Part C), vary widely in terms of coverage, but typically only cover short-term stays in a nursing home if someone needs skilled nursing care.

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Key Takeaways

  1. Medicare may cover up to 100 days in a nursing home after certain hospital stays and if skilled nursing is needed.
  2. Medicare may pay in full for days 1 through 20 and partially for days 21 through 100 of a nursing home stay.
  3. After day 100, some care costs are still covered, such as certain supplies, devices, and other aspects of medical care.
  4. Coverage provided by Medicare Part C or Medicare Advantage plans varies, so it’s important to thoroughly read and understand individual policies.

Medicare and nursing homes

Medicare Part A, also called Hospital Insurance, will 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.

Medicare Part B pays for outpatient care and services and won’t cover a nursing home stay.

Medicare defines three categories of coverage for a nursing home stay: custodial care, skilled nursing, and supplies and equipment.

Custodial care

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. If custodial care is the only kind of care provided during a nursing home stay, Medicare won’t cover it.[01]

Skilled nursing care

Skilled nursing carerequires the provider to have a degree or certification. Skilled care generally includes:[02]

  • 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

Medical supplies and equipment

Medicare typically pays for medical supplies and equipment that someone uses during a nursing home stay, such as:[02]

  • Wheelchairs, oxygen, and walkers
  • Bandages, syringes, or incontinence supplies

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Who qualifies for Medicare nursing home coverage?

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

  • 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 only accept patients who can pay out of pocket.
  • Have been discharged from a hospital stay of at least three days. Not all hospital stays qualify. When your loved one is checked in at the hospital, ask whether they’re being admitted or are only there for observation. Even if they stay overnight, observation periods aren’t the same as inpatient stays. Only after someone has been admitted to the hospital as an “inpatient” by a doctor’s order will they qualify.[03]
  • 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, a hospital discharge planner will recommend facilities for your loved one to move into after their hospital stay. Keep in mind that there may be waiting lists.
  • Need daily skilled nursing care. If your loved one needs help with ADLs but doesn’t require medical care from a skilled nursing or therapy staff, Medicare won’t pay for their nursing home stay.[01]
  • 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 for days 21 through 100. Medicare stops covering custodial costs after 100 days, but will cover skilled or medical care services after that.

How much will Medicare pay for a nursing home?

Medicare Part A covers 100% of the costs for the first 20 days of eligible nursing home stays. On day 20, your loved one may have to pay up to $209.50 a day in coinsurance costs.[04] Coverage of nursing home care stops after day 100.[04] If your loved one needs to stay in the nursing home longer, your family may have to rely on other resources to pay for care, such as long-term care insurance.

In 2024, the median monthly cost of a semi-private room in a U.S. nursing home was $9,277.[05] So, even if your loved one paid the maximum of $209.50 in coinsurance for 80 days, they’d pay $16,760 for a full 100-day stay, instead of over $24,000.

Medicare Advantage plans and nursing homes

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.[04]

If your loved one has a Medicare Advantage plan, the plan may cover some of the costs of medical care in a nursing home or skilled nursing facility, but it won’t cover custodial care, help with ADLs, or monthly rent.

Medicare Advantage plans may have different rules regarding coinsurance. In some plans, the first 20 days of nursing home care aren’t fully covered, so the policyholder may have to pay coinsurance expenses beyond $209.50 per day throughout their stay.

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 later.[04]

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Help after a nursing home stay

If your loved one needs help once they leave the nursing home, there are multiple potential options to pursue. Assisted living communities also offer safe, supportive residential environments. If your loved one prefers to stay in their own home, in-home care supports their independence while also providing respite for family caregivers.

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.

Families also ask

Medicare won’t cover the cost of living in a nursing home for someone who has dementia. It does, however, pay for some medical services and equipment related to dementia care. Examples include cognitive assessments, care planning, and some medically necessary custodial services.

Like Medicare,  Tricare doesn’t cover custodial care. It may cover certain services and supplies, however. Tricare coverage varies according to the plan though, so it’s important to read policies carefully and understand what they’ll cover, ideally before care is needed.

Medicare won’t pay for custodial care for someone who has Parkinson’s disease, if that’s all that’s needed. However, people who have Parkinson’s often need skilled nursing care, equipment, and supplies that Medicare will pay for.

Yes. Original Medicare, Part A and Part B, will cover all hospice services related to someone’s terminal illness if they meet specific conditions. What Medicare won’t cover is rent or room and board in a long-term care facility, including nursing homes.

SHARE THE ARTICLE

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

  2. Centers for Medicare and Medicaid Services. Skilled nursing facility care.

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

  4. Centers for Medicare and Medicaid Services. (2025). Costs.

  5. Genworth. (2024). Cost of care survey.

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.
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Edited by
Tori Newhouse
Tori Newhouse is a Manager of Content Strategy at A Place for Mom. She has more than 15 years' experience in publishing and creating content. With a background in financial services and elder law, her passion is to help readers to plan ahead and plan for their ideal retirement. She holds a bachelor's degree in English from Gordon College.
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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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