Medicare and Long-Term Care
Find out Whether Medicare Helps Pay for Long-Term Care
What It Is
Long-term personal (often called "custodial") care in a nursing home, assisted-living facility, or at home
Neither Medicare Part A nor Medicare Part B -- nor a Medicare Part C Medicare Advantage plan -- covers long-term custodial (nonmedical) or residential care, in any setting.
Note regarding short-term skilled nursing-facility or in-home care: Medicare, or a Medicare Part C Medicare Advantage plan, may cover short-term, limited care in a skilled nursing or rehabilitation facility, or part-time in-home care, under certain conditions. See Medicare Coverage of Nursing Facility Care and Medicare Coverage of In-Home Care.
What Medicare Pays
Neither Medicare nor a Medicare Part C plan pay anything for long-term custodial care.
Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:
The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?
The care must be performed or delivered by a healthcare provider who participates in Medicare.