Does Medicare Cover Long Term Care?
No — Medicare does not cover long-term custodial care. It pays for up to 100 days of skilled nursing or rehab per benefit period after a qualifying 3-day inpatient hospital stay (days 21–100 carry a daily copay), and limited intermittent skilled home care. Ongoing help with bathing, dressing, and daily living is excluded entirely.
What Medicare actually pays
| Care situation | Medicare's role |
|---|---|
| Rehab in a skilled nursing facility after a 3-day inpatient hospital stay | Days 1–20 fully covered; days 21–100 with a daily coinsurance (about $210/day in 2025, indexed); nothing after 100 days |
| Skilled home health (nurse/therapy ordered by a doctor) | Covered while you qualify — intermittent visits, not daily aides |
| Hospice | Covered for terminal illness — comfort care, not custodial support |
| Ongoing custodial care at home, assisted living, or a nursing home | Not covered — ever |
The traps inside the rules
- Observation status: hospital time coded as “observation” doesn't count toward the 3-day inpatient requirement — families discover this at the nursing home's billing desk. Always ask whether admission is inpatient.
- “Improvement” myths: coverage requires skilled need, not improvement — but once care is purely custodial, coverage ends regardless.
- Medicare Advantage: some plans add modest in-home support benefits, but none cover long-term custodial care.
- Medigap: fills Medicare's copays — including SNF coinsurance — but only within Medicare-covered services; it adds nothing after day 100.
Who actually pays for long-term care
Personal savings first, then Medicaid after assets are spent down, VA programs for qualifying veterans, and private LTC insurance for those who bought it while insurable. The full menu, including self-funding, is in alternatives.
Frequently asked questions
How many days of nursing home care does Medicare cover?
Does Medicare pay for assisted living?
Does Medicare Advantage cover long term care?
Does Medigap help with long term care?
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