If you are 65 or older and require skilled nursing care, Medicare will cover your stay in a Certified Nursing Facility, but only if a doctor has deemed it medically necessary. Medicare will not cover a stay for patients who need custodial care, though.

Does Medicare cover nursing homes?

Medicare covers nursing home care only in instances where a doctor has determined you require daily, skilled nursing care for treating a hospital-related medical condition. 

To be eligible for Medicare nursing home coverage you must have first had a qualifying hospital stay. Your nursing home care will be covered under your Medicare Part A benefits which cover hospitalization, skilled nursing care, lab tests, surgery, and home health care.

Medicare coverage for nursing home care is limited to 100 days and the patient must be receiving skilled care for recovery after an inpatient hospitalization.

Medicare nursing home coverage eligibility

For your nursing home costs to be covered by Medicare, you must meet the following criteria:

• Your doctor must determine that your condition requires skilled nursing care;
• You must have first had a qualifying hospital stay of at least 3-day-consecutive inpatient hospitalization;
• You must receive care at a Medicare-approved skilled nursing facility; 

What nursing home services are covered by Medicare?

If you meet the eligibility criteria described above, Medicare will cover the cost of the following services:

• a semi-private room;
• medical supplies and equipment;
• medications;
• occupational therapy;
• physical therapy;
• skilled nursing care;
• speech or language therapy;
• ambulance transportation to healthcare providers;
• meals;
• medical social services;

When does Medicare not cover nursing home care?

Medicare does not cover nursing home service if the only care you need is custodial. This means that you will not receive coverage if you go into a nursing home for help with daily activities like bathing, eating, dressing, and using the bathroom.

Your Medicare Plan A benefits will also not cover nursing home care beyond 100 days even if the patient is receiving skilled nursing care. This means that after 100 days of coverage all costs revert back to the patient. 

Which Medicare plans cover nursing homes?

1. Medicare Part A: If you have original Medicare, you can be covered for nursing home care under your Part A benefits provided you meet the eligibility criteria. Part A benefits will cover skilled nursing care in a nursing home for up to a maximum of 100 days.
2. Medicare Advantage: You can get coverage for nursing home care with a Medicare Part C or Medicare Advantage plan. Medicare Advantage Special Needs Plans (SNPs) offer coverage for custodial care for patients with qualifying chronic conditions.  
3. Medicare Part D: Medicare Part D offers prescription drug coverage and it can be used to cover the cost of prescription drugs needed while a patient is living in a nursing home. 
4. Medigap: Medigap does not cover long-term care but it can help to cover the copayments incurred when Medicare Part A covers your skilled nursing care at a nursing home. 

For how long and how much does Medicare pay for nursing home?

Medicare will cover nursing home costs as follows:

• Days 1 to 20: Medicare pays for the full cost of the nursing home care received; 
• Days 21 to 100: For days 21 through 100, Medicare will cover the cost of skilled nursing care but you are required to copay $204 coinsurance per day in 2024;
• Days 101+: Medicare does not cover skilled nursing care at a nursing home beyond 100 days. Once the benefit period ends the patient has to bear all costs; 

Does Medicare pay for nursing homes for Alzheimer’s patients?

Medicare does not pay for long-term custodial care at a nursing home for patients with Alzheimer’s. If your doctor has determined that you need skilled nursing care, Medicare will pay for nursing home care for up to 100 days like in all other cases.

Medicare does cover some of the health care services for patients with Alzheimer’s including:

• Medicare Part A covers inpatient hospital care and some of the doctors’ fees; 
• Medicare Part D covers most of the prescription drugs required by Alzheimer’s patients; 
• Medicare Part A will pay for up to 100 days of skilled nursing home care;

Nursing homes that accept Medicare

Even if you meet the Medicare eligibility criteria for nursing home coverage, Medicare will only cover costs if you go to a Medicare-approved facility. 

If you are in hospital care, your doctor or social worker will be able to find a nursing home that meets your medical needs and is certified by Medicare. Your caregiver or hospital staff should also arrange your transfer to the nursing home.

Medicare also has helpful resources to help you find nursing homes that accept Medicare in your area. 

Options that help pay for nursing home care

If you need help to cover nursing home care, there are other options other than Medicare that can help. These include:

Medicaid

Medicaid is a federal program available to people from low-income households. Medicaid can help cover nursing home costs for people who meet the eligibility criteria. Medicaid will cover 100% of nursing home costs in most cases if you meet eligibility requirements including skilled nursing care, rehabilitation, and long-term care at a nursing home. 

Private Insurance

You can purchase long-term care insurance from private insurance companies to help cover part or all of the costs of nursing home care. However, these types of plans are best purchased early since premiums tend to increase with age.

Veterans Administration

If you need coverage for long-term nursing home care and you served in the military, you may qualify for aid through the United States Department of Veterans Affairs.

Article updated on November 9, 2023.