Does Medicare Cover Nursing Home Care?

Only briefly, and only in one situation. Medicare covers up to 100 days in a skilled nursing facility after a qualifying hospital stay. It does not pay for long-term custodial care, which is the help with bathing, dressing and daily living that most nursing-home residents actually need.

If you're planning for care that lasts, the payer is usually Medicaid: see how Medicaid pays for a nursing home. The difference between the two programs is laid out on Medicaid vs Medicare.

What Medicare does cover

Medicare Part A pays for a skilled nursing facility stay when three things are true: the person had a qualifying inpatient hospital stay first, a doctor certifies they need daily skilled care, and the facility is Medicare-certified.

Within a benefit period, the first 20 days are covered in full. Days 21 through 100 carry a daily copayment the resident pays. After day 100, Medicare pays nothing toward that stay.

Skilled care versus custodial care

This distinction decides everything, and it isn't about how sick someone is. Skilled care is treatment that requires a licensed professional: wound care, intravenous medication, physical therapy after a stroke or a fracture.

Custodial care is help with the activities of daily living: eating, bathing, dressing, using the toilet, moving safely. Someone can need that help constantly, for years, and Medicare will not pay a dollar toward it. Most long-term nursing-home care is custodial.

Why does coverage end before 100 days?

Because 100 days is a maximum, not an allowance. Coverage continues only while the person still needs daily skilled care and is benefiting from it. Once therapy goals plateau, the skilled need ends and so does payment, often well before day 100.

Families are frequently told the resident "has 100 days" on admission and then receive a notice a few weeks later. That notice is appealable. You can request an expedited review, and appeals do sometimes succeed, particularly where the person still needs skilled care to maintain their condition rather than improve it.

What happens when Medicare stops?

The bill becomes yours from that day. At a national median of about $9,581 a month for a shared room, private savings go quickly, which is why the transition to Medicaid is the moment most families are really planning for.

Cost figure is a national median from the CareScout Cost of Care Survey, data collected July to November 2025. Last verified July 30, 2026.

Start the Medicaid application before Medicare coverage runs out rather than after. Processing commonly takes 45 to 90 days, and the gap between the two is where families end up paying out of pocket unnecessarily. See who qualifies for Medicaid.

Common questions

How many days will Medicare pay for a nursing home?

Up to 100 days per benefit period, with the first 20 fully covered and a daily copayment for days 21 to 100. In practice many stays end sooner, when the person no longer needs daily skilled care.

Does a hospital stay always qualify me?

No. It must be an inpatient admission, and time spent under observation status does not count even when you slept in a hospital bed. Ask directly whether your parent is admitted as an inpatient or held under observation.

Does Medicare Advantage cover more?

Advantage plans must cover at least what original Medicare does, and some offer extra days or waive the hospital-stay requirement. They also use their own authorization rules, so check the specific plan rather than assuming either way.

Can I appeal when coverage ends?

Yes, and you should if the person still needs skilled care. The facility must give you written notice with appeal instructions, and a fast-track review is available. Deadlines are short, sometimes only a day or two, so act immediately.

Sources

• CareScout, "Cost of Care Survey," data collected July through November 2025, for the nursing home cost figure.
• Centers for Medicare and Medicaid Services, "2026 SSI, Spousal Impoverishment, and Medicare Savings Program Resource Standards," CMCS Informational Bulletin, December 9, 2025.

Written and reviewed by Owen Hastings. Last reviewed July 30, 2026. Read our editorial policy for how we source and check these figures.