Medicare & Insurance

Does Medicare Pay for a Nursing Home or Home Care? What Is and Is Not Covered

By Maren Hale / November 10, 2026

Original Medicare pays for a limited kind of nursing facility care: short-term “skilled” care that follows a hospital stay and helps you recover. It does not pay for long-term stays where the main need is help with everyday tasks such as bathing, dressing or eating. Home care follows a similar rule. Medicare covers part-time nursing and therapy at home when you meet certain conditions, but not round-the-clock help or housekeeping. This guide explains each rule in plain steps, using figures that Medicare.gov lists for 2026.

Key takeaways

Medicare covers skilled nursing facility care only after a hospital stay of at least 3 days in a row as an inpatient, and only while you need daily skilled care.
In 2026, a covered stay costs $0 a day for days 1 to 20, then $217 a day for days 21 to 100. After day 100, you pay everything.
Medicare says plainly that it does not pay for long-term care, which is mostly non-medical help with daily tasks.
Home health care is covered when you are homebound and need part-time skilled services, but 24-hour care and meal delivery are not.
Free, unbiased help is available from your State Health Insurance Assistance Program and from 1-800-MEDICARE.

First, two kinds of care that sound alike

Skilled care is care that needs trained nurses or therapists. Examples are wound care, physical therapy after a hip surgery, or injections. Medicare can help pay for this when you meet its conditions.

Custodial care, which Medicare calls long-term care, is mostly non-medical help with daily living. It includes bathing, dressing, using the bathroom, and eating. Medicare.gov says Medicare does not pay for it, and that Medigap policies (private insurance that fills gaps in Original Medicare) and most other health insurance do not either.

A person can need both at different times. Once only help with dressing and meals is needed, coverage stops, even if the person is still in the same bed.

Skilled nursing facility care: the rules

A skilled nursing facility, often shortened to “SNF,” is a place certified by Medicare to provide nursing and therapy. Here are the conditions listed on Medicare.gov.

A hospital stay first. You must have been a hospital inpatient for at least 3 days in a row. Days spent under “observation” or in the emergency room do not count, even if you stayed overnight. Ask the hospital whether you have been formally admitted as an inpatient.
A timely move. You generally need to enter the facility within 30 days of leaving the hospital.
A daily skilled need. A doctor or other provider must decide you need skilled care every day, given by or under the supervision of nursing or therapy staff.
A related condition. The need must connect to a condition treated during the hospital stay, or to a new condition that began while you were receiving that care.
A certified facility, and days left. The facility must be Medicare-certified, and you must still have days available in your benefit period.

A “benefit period” is the way Medicare counts your hospital and facility use. You pay the Part A deductible each time a new one starts, and there is no limit on how many you can have in a year.

What it costs in 2026

Medicare.gov lists these 2026 amounts for each benefit period. They change yearly.

Days 1 to 20: $0 per day.
Days 21 to 100: $217 per day.
Day 101 and after: you pay all costs.

Covered services include a semi-private room, meals, skilled nursing, therapy, medications, medical supplies used in the facility, and dietary counseling. The amounts above are for Original Medicare. Medicare.gov notes that Medicare Advantage plans may charge copayments in the first 20 days.

The 3-day rule can sometimes be waived

Medicare.gov says the 3-day requirement may be waived if your doctor belongs to an accountable care organization (a group of providers that coordinates care) with a waiver, or if your Medicare Advantage plan waives it. Do not assume this applies to you. Ask in advance.

Home health care: what is covered at home

Home health care means skilled services delivered where you live. Medicare.gov lists these conditions.

You need part-time or occasional skilled services, such as nursing or therapy.
You are “homebound.” This means that leaving home is not recommended, or takes a lot of help or effort, because of an illness or injury, and you are normally unable to leave.
A doctor or other qualified provider has seen you in person, confirmed the need, and ordered the care.
A Medicare-certified home health agency provides it.

Short outings for medical care, religious services, or adult day care do not disqualify you. You pay nothing for covered home health services. For equipment such as a walker, you pay 20 percent of the Medicare-approved amount after the Part B deductible.

A home health aide can be covered, but only part-time, and only while you also receive skilled nursing or therapy. Not covered: 24-hour care at home, home-delivered meals, housekeeping or shopping unrelated to your care plan, and personal care such as bathing or dressing when it is the only help you need.

Before giving you something Medicare will not pay for, the agency should tell you in advance, in a written notice, so you can decide whether to go ahead.

Hospice care

Hospice is comfort care for a person with a terminal illness. Medicare.gov says you qualify when you have Part A, your hospice doctor (and your regular doctor, if you have one) certify a life expectancy of six months or less, you choose comfort care instead of treatment aimed at a cure, and you sign an election statement.

Hospice from a Medicare-approved provider costs you nothing. Prescriptions for pain and symptom control may carry a copayment of up to $5 each. Short respite stays, which give family caregivers a break, cost 5 percent of the Medicare-approved amount.

One point surprises many families. Medicare does not pay for room and board during hospice at home, in a nursing home or in a hospice facility.

At a glance: what Original Medicare covers

Type of care	Does Original Medicare cover it?	Key condition
Skilled nursing facility stay	Yes, for a limited time	3-day inpatient hospital stay first, daily skilled need, up to 100 days per benefit period
Long-term nursing home stay for daily living help	No	Medicare does not pay for long-term care
Home health nursing and therapy	Yes	Homebound, part-time skilled care, doctor’s order, certified agency
Bathing or dressing help only, at home	No	Covered only when you also receive skilled care
24-hour care at home	No	Not covered
Home-delivered meals, housekeeping	No	Not covered
Hospice	Yes	Terminal illness, six months or less, comfort care chosen
Room and board during hospice	Generally no	Short respite stays arranged by hospice are covered

If you have a Medicare Advantage plan

Medicare Advantage, also called Part C, is a way to receive Medicare benefits through a private plan. Medicare.gov says to check with your plan about nursing home coverage, and that plans usually do not help pay unless the nursing home has a contract with the plan.

That makes the network important. Before agreeing to a facility, ask the plan whether it is in the network and what you would owe each day.

Where payment can come from instead

Medicare.gov lists several ways people pay when Medicare does not.

Personal funds. The page says most people who enter a nursing home start by paying themselves.
Medicaid. This is a joint federal and state program for people with limited income and, in some cases, limited resources. Rules differ by state, and most but not all nursing homes accept it. Contact your state Medicaid office to ask about eligibility.
Long-term care insurance. Policies vary widely. Some cover only nursing homes. Others also cover adult day care, assisted living, equipment and home care. Medicare.gov suggests checking whether pre-existing conditions limit coverage and buying only from a company licensed in your state.

The Department of Veterans Affairs lists VA programs among the ways to pay for long-term care, and refers readers to a VA social worker for details on eligibility and services. Ask a VA social worker what applies.

Where to get free, unbiased help

Medicare.gov says State Health Insurance Assistance Programs, called SHIPs, give free, personalized counseling to people with Medicare and their families, and are not connected to any insurance company or health plan. Counselors can discuss your rights, billing problems, and how Medicare works with other insurance.

To find yours, visit shiphelp.org or call the national SHIP center at 877-839-2675. For questions about Original Medicare benefits and costs, call 1-800-MEDICARE (1-800-633-4227). Medicare lists the line as available 24 hours a day, 7 days a week, with some federal holidays excluded. People who use TTY equipment can call 1-877-486-2048.

Questions to ask a facility or agency

Use this checklist when you speak to a nursing facility or home health agency. Write down the answers and the name of the person who gave them.

Is the facility or agency certified by Medicare?
Will the bill go to Original Medicare, a Medicare Advantage plan, or Medicaid?
Was I admitted as an inpatient or kept under observation?
If I have a Medicare Advantage plan, is this provider in its network?
What daily amount will I owe, and from which day?
Which services will Medicare not pay for?
If coverage ends, what is the private daily rate, and does the facility accept Medicaid?
How much notice will I get when I no longer need skilled care?

Frequently asked questions

Does Medicare pay for a nursing home if I live there for years?

No. Medicare.gov says it generally does not cover long-term nursing home stays unless you are receiving skilled nursing care. Skilled stays are limited to 100 days per benefit period.

Does time in the emergency room count toward the 3 days?

No. Observation and emergency room time does not count, even overnight. Ask the hospital about your status.

Will Medicare pay for someone to help me bathe and dress at home?

Only in a limited way. A home health aide may be covered part-time while you also receive skilled nursing or therapy. Personal care as your only need is not covered.

Can I use Medicare Advantage to pay for long-term care?

Medicare.gov says to check with your plan, and notes that plans usually do not help pay unless the nursing home is in the plan’s network. Plan benefits differ, so ask for the details in writing.

Before you decide

Coverage turns on small details, such as your admission status and your plan type. Ask questions early, and ask for answers in writing. A free call to a SHIP counselor, before a move or before signing papers, is a sensible first step. Figures here are Medicare.gov’s 2026 amounts, and they change each year.