Does Medicare Cover Long-Term Care? Skilled Nursing, Home Health & Hospice
Medicare pays for skilled care with an end point: a rehab stay, home health visits, hospice. It does not pay for ongoing help with daily living. Here is where each benefit stops.
No. Medicare does not pay for ongoing custodial care, meaning help with bathing, dressing, eating or supervision when there is no skilled medical need. It covers three narrower things: up to 100 days in a skilled nursing facility per benefit period after a qualifying hospital stay, home health visits when a doctor certifies that a homebound patient needs intermittent skilled care, and hospice for a terminal illness. Ongoing custodial care is paid for by Medicaid, long-term care insurance or the family. Our long-term care Medicaid estimator covers the Medicaid side.
Many people expect Medicare to work as general health insurance for old age. It is built to pay for skilled, medically necessary care that has an end point. The sections below cover each benefit and its limits.
Skilled nursing facility care: up to 100 days, for recovery
Medicare Part A covers a stay in a skilled nursing facility (SNF) for rehabilitation after a hospital stay. Three conditions apply:
- An inpatient hospital stay of at least 3 consecutive days right before the SNF admission. Time under "observation status" does not count as inpatient, so ask the hospital which status you are in.
- A need for skilled nursing or therapy.
- The care is for a condition related to the hospital stay.
One narrow exception began in 2026. Hospitals in CMS's Transforming Episode Accountability Model (TEAM) can waive the 3-day rule for certain surgeries. Most beneficiaries are outside that pilot, and the 3-day rule applies to them as before.
| Days in a benefit period | You pay (2026) |
|---|---|
| 1 to 20 | $0 |
| 21 to 100 | $217 a day (was $209.50 in 2025) |
| 101 and after | All costs |
A full 100-day stay costs 80 days at $217, which is $17,360, unless a Medigap or Medicare Advantage plan covers the coinsurance. After day 100, Medicare pays nothing for that benefit period, even if skilled care is still needed. A benefit period ends once you have gone 60 days in a row without inpatient hospital or skilled nursing care.
Coverage can also end before day 100 if the facility decides you no longer need skilled care. You can challenge that with a fast appeal. The benefit suits a rehab stay after a hip fracture or stroke. It does not cover living in a nursing home.
Home health: skilled and intermittent
The home health benefit needs no prior hospital stay and has no day limit. A doctor has to certify two things:
- You are homebound. Leaving home takes considerable effort. Trips for medical care, religious services and occasional short outings are allowed.
- You need skilled nursing or therapy on an intermittent basis, not full-time.
When both are met, Medicare covers the skilled visits and home health aide visits under the same plan of care, at no cost to you.
"Intermittent" is the limit. The benefit typically means nursing or therapy visits a few times a week. It does not provide a daily aide. If the need is someone to supervise a person with dementia, or to help with bathing and meals with no skilled care involved, that is custodial care, and Medicare does not cover it by itself.
Skilled Nursing Facility
Up to 100 days per benefit period, after a 3-day qualifying hospital stay. Days 1-20 free, days 21-100 at $217/day (2026), day 101+ you pay all costs.
Home Health
No prior hospital stay and no day limit. Requires homebound status and a doctor-certified skilled, intermittent need. $0 cost-sharing when covered.
Hospice
For a terminal prognosis of 6 months or less. Nearly fully covered: up to $5 copay on pain drugs, 5% coinsurance on inpatient respite care.
Custodial Long-Term Care
Ongoing help with daily activities and no skilled need. Not covered by Medicare. Medicaid covers it for people who qualify.
Hospice: the most complete benefit
Hospice has the lowest cost-sharing of any Medicare benefit in this area. To qualify, a hospice doctor and the patient's own doctor certify a terminal illness with a life expectancy of 6 months or less. The patient chooses comfort care in place of curative treatment for that illness.
Medicare then covers nursing visits, medical equipment, counseling, and drugs for pain and symptom control. The patient pays at most:
- a copay of up to $5 for each prescription for pain relief or symptom control
- 5% coinsurance for inpatient respite care, a stay of up to 5 consecutive days that gives a family caregiver a break
Hospice does not pay room and board in a nursing home or assisted living facility. It covers the hospice care delivered there.
Where Medicaid takes over
Ongoing custodial help for someone who can no longer manage daily life alone is Medicaid's job. Medicaid pays for it through nursing home coverage or state Home and Community-Based Services (HCBS) waivers. There is no skilled-need requirement, but there are strict income and asset limits.
These articles and tools cover that side:
- The Medicaid look-back period and penalty math
- Medicaid spend-down myths
- Community spouse allowance calculator
- Does Medicaid pay for assisted living?
For planning, count on Medicare for a short rehab stay or a period of skilled home health visits. Plan separately for long-term care through savings, long-term care insurance or Medicaid.
Frequently Asked Questions
Does Medicare pay for long-term care in a nursing home?
No, not ongoing custodial care. Medicare pays for a nursing home stay only when it is for skilled nursing or rehabilitation after a qualifying hospital stay, and coverage is capped at 100 days per benefit period. If someone needs ongoing help with bathing, dressing or eating and has no skilled medical need, Medicare does not cover the stay.
How many days will Medicare pay for a skilled nursing facility?
Up to 100 days per benefit period, and only after an inpatient hospital stay of at least 3 consecutive days. The first 20 days are covered in full. Days 21 through 100 have a daily coinsurance of $217 in 2026. After day 100, Medicare pays nothing.
Does Medicare cover home health aides?
Only in a limited way. The home health benefit covers skilled nursing and therapy visits, plus home health aide services, when a doctor certifies that you are homebound and need intermittent skilled care. It does not cover a full-time aide hired only for custodial help such as bathing or meal preparation. Covered visits have no cost-sharing.
What's the difference between Medicare's home health benefit and Medicaid's coverage of long-term care?
Medicare's home health benefit requires a doctor-certified skilled need and is short-term and intermittent. Medicaid, through nursing home coverage or state HCBS waivers, pays for ongoing custodial care with no skilled-need requirement, but you have to meet its income and asset limits.
What does Medicare's hospice benefit cover?
Care related to a terminal illness with a life expectancy of 6 months or less: nursing visits, medical equipment, drugs for pain and symptoms, counseling, and up to 5 days of inpatient respite care. You pay up to a $5 copay for pain-relief prescriptions and 5% coinsurance for respite care.
This article explains general federal Medicare coverage rules as of October 2026 and is not medical, legal or financial advice. Coverage depends on your diagnosis, your doctor's certification and your plan type. Medicare Advantage plans may apply their own rules within federal minimums. For your own situation, contact Medicare or a State Health Insurance Assistance Program (SHIP) counselor.