Does Medicare pay for nursing home or long-term care?

When does Medicare cover a skilled nursing facility?

Part A covers care in a skilled nursing facility (SNF) when you need daily skilled care, such as physical therapy or IV medication, after a qualifying inpatient hospital stay of at least 3 days in a row. The days start the day you're formally admitted; time in the emergency room or under observation, even overnight, doesn't count. You generally must enter the facility within 30 days of leaving the hospital, for a condition treated there.

In 2026, you pay $0 for days 1 to 20, $217 a day for days 21 to 100, and all costs after day 100 of a benefit period. A new benefit period starts after 60 days in a row without inpatient or skilled nursing care.

What is observation status, and why does it matter?

A hospital can keep you under observation as an outpatient without admitting you. Those days don't count toward the 3-day stay that SNF coverage requires, and Part B, not Part A, pays for them. If you're in the hospital more than 24 hours as an outpatient, it must give you a Medicare Outpatient Observation Notice (MOON). Ask whether you've been admitted as an inpatient.

Some Medicare Advantage plans waive the 3-day hospital stay requirement, as do some doctors and hospitals in Medicare's accountable care organizations.

Does Medicare cover care at home?

Yes, if you're homebound and need part-time skilled nursing or therapy under a plan of care your doctor sets. You pay $0 for covered home health services and 20% of the Medicare-approved amount for medical equipment. Medicare doesn't cover 24-hour care at home, meals delivered to your home, or homemaker and personal care services when they're the only care you need.

What about hospice?

Part A covers hospice for people with a terminal illness and a life expectancy of 6 months or less who choose comfort care. You pay $0 for covered hospice services, up to $5 for each prescription for pain and symptom control, and 5% of the cost of inpatient respite care. Room and board in a nursing home isn't covered by hospice.

Who pays for long-term care if Medicare doesn't?

• Medicaid, for people whose income and resources meet their state's limits; most nursing home residents who stay long term rely on it. See Medicare vs. Medicaid.
• Long-term care insurance, bought before you need care.
• PACE (Programs of All-Inclusive Care for the Elderly), available in some areas, for people who need a nursing-home level of care but can live safely in the community.
• Personal savings and family.