Does Medicare Pay for Nursing Homes?

With more than 15,000 nursing homes in the U.S. — which together offer roughly 1.6 million beds — it's clear that many older adults need a higher level of care than they can receive in their homes. 

Nursing homes, also called skilled nursing facilities (SNF), are often the best choice for seniors who need long-term care, also known as "custodial care," on a daily basis. Older adults prescribed shorter-term rehabilitation care following a hospital stay can also benefit from SNFs.
Carescout's Cost of Care report reveals that nursing home care isn't cheap, so many seniors and caregivers may be left asking, "Does Medicare pay for nursing homes?" It depends. Medicare does not cover custodial care but provides some financial support for short-term SNF stays. Explore when you can receive Medicare nursing home coverage in this helpful guide.

 

If your loved one lives in a nursing home rather than their own home or an independent living, assisted living, or memory care setting, this is likely classified as custodial care. 

Custodial care assists with activities of daily living (ADLs), like bathing, eating, and toileting. Someone living in an SNF is likely to need this kind of aid on a daily basis. They are also likely to need the daily care of nurses or other healthcare professionals. Medicare does not pay for custodial care. 

Medicare may cover costs if your senior is only a nursing home resident for a short period following a hospital stay of three days or more. For insight into Medicare nursing home coverage, consider the questions below.

For Medicare to pay for care in an SNF, your senior must have spent at least three days as an inpatient for a medically necessary reason in the preceding 30 days. Medicare starts this period upon admission but does not include the discharge day. Time spent in the hospital as an outpatient or under observation does not count towards the three-day inpatient requirement

They must be signed up and receiving Medicare Part A coverage. Most older adults register for this care when they reach 65. They must also have days of SNF coverage available to them for the benefit period in question. 
Part A includes 100 days of SNF coverage for each benefit period, and a year can comprise multiple benefit periods if eligibility is met. This stage begins the day you enter the hospital and ends when you have been out of the hospital for 60 consecutive days.  Medicare Advantage (or Medicare part C) plans may have additional requirements, like prior authorization.

According to Medicare, a doctor who has treated the senior must deem the care "reasonable and necessary" to order the SNF services, which need to be delivered on a daily basis. The care must also relate to an ongoing condition treated during a qualifying hospital stay, even if it wasn't the primary reason for the stay. 

For example, if you are in the hospital because you broke your hip and, while there, had a stroke, your rehabilitation for the stroke is an acceptable reason for Medicare to pay for the SNF.

Individuals must receive care at Medicare-certified SNFs. Medicare offers a Care Compare Tool with search options that allow users to compare nursing facilities based on location, quality of care, and staffing.

What does Medicare cover in nursing homes? After qualifying for a short-term stay, this service covers your room and board costs for a semi-private room, meals, dietary counseling, and medications. It will cover the costs of the skilled nursing care you receive while there, along with any required medical social services. 

Medicare nursing home coverage also includes medical supplies and equipment you may need, as well as ambulance transportation to another location if the services you need are unavailable at the facility. In addition, it covers any therapy services — physical, occupational, and speech-language pathology when deemed medically necessary. 

Original Medicare covers these costs for the first 20 days you are in an SNF, as of 2025. You will have a copay of $209.50 for days 21-100. After day 100, you will pay all costs yourself. The copay generally increases each year.

Medicare Part C, also known as Medicare Advantage, refers to programs that offer Medicare coverage through private insurers rather than the government. It bundles several types of coverage, including Medicare Parts A, B, and sometimes D, into a single plan. 

Advantage plans must offer at least the same levels of coverage as Original Medicare but may include more. Because each insurer sets rates, your premiums, copays, and coinsurance costs may differ from what you would pay for Original Medicare.
Medicare Part C pays for SNF care like Original Medicare: you will be covered for a limited number of days following a qualifying hospital stay. If you would rather receive care in your home rather than an SNF, your Advantage plan may include coverage, as well. Since each plan differs, however, you will need to review your policy documents or speak with a company representative to determine your coverage.

We've looked at how long Medicare covers nursing home care, but what about if you or your loved one needs long-term stay coverage? Since Medicare coverage is limited, you may need to find other resources to pay for your stay in a nursing home. 

Social security benefits may be one option to help cover costs. There may be other ways to pay for nursing homes. If you have previously purchased long-term care insurance, you may have financial help with costs. 
However, you would have to have purchased the insurance well before the need arose — most insurers will not cover you if you're already seeking care. Reverse mortgages can provide income for long-term care, as can family resources, savings, and investments.

To start your search, use the Medicare Nursing Home Compare Tool. This resource locates Medicare-certified SNFs in your region and offers overall ratings and information about each facility, such as the number of certified beds and other pertinent data.

A free Centers for Medicare and Medicaid Services booklet titled "Your Guide to Choosing a Nursing Home or Other Long-Term Services and Supports" provides insights and data on finding the right nursing home for yourself or your loved one.

Does Medicare pay for nursing homes? Yes, but only in certain cases. If you need short-term care in a skilled nursing facility after a hospital stay, Medicare will pay — with some limits. If you or your loved one needs long-term care in a nursing home, however, rather than living in an assisted living facility or retirement home, Medicare is not likely to cover the costs.

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