Medicare helps pay for the costs of many services, however, it pays a limited amount of long-term support services, and generally doesn’t pay for most nursing home care.
Under certain limited conditions, Medicare will pay some nursing home costs for those who require skilled nursing or rehabilitation services. To be covered, you must receive the services from a Medicare certified skilled nursing home after a qualifying hospital stay. A qualifying hospital stay is the amount of time spent in a hospital just prior to entering a nursing home. This is at least three days.
How do I pay for long-term nursing home care?
There are several ways to pay for long-term nursing home care:
- Personal resources: You can use your savings to pay for care. You may also want to check with your life insurance company to see if your policy can help pay for long-term care.
- Medicaid: People with limited incomes and resources may be able to get Medicaid. Not all nursing homes accept Medicaid payment. To find out if you can get Medicaid, contact your state Medicaid office.
- Long-term care insurance: Long-term care insurance can vary widely. Some policies may cover only nursing home care. Others may include coverage for a whole range of services, like adult day care, assisted living, medical equipment, and informal home care.
Do I need to apply for/keep my Medicare if I’m entering a nursing home?
You will want to enroll in or keep your Medicare coverage if you're entering a nursing home. Even if it does not cover nursing home care, you'll need health coverage for hospital care, doctor services, rehabilitation services, and medical supplies while you are in the nursing home.
If you have Medicare & live in a nursing home or other institution, you should also know:
- You may still want to enroll in a Part D plan to cover the costs of your drugs.
- If you aren't able to join a Part D plan on your own, your authorized representative can enroll you in a plan that meets your needs.
- If you're in a skilled nursing facility (SNF) getting Medicare-covered skilled nursing care, your medical care, including prescriptions, generally will be covered by Part A.
- Long-term care pharmacies contract with Medicare prescription drug plans to provide drug coverage to nursing home residents. If you're entering, living in, or leaving a nursing home, you'll have the opportunity to choose or switch your Medicare drug plan. This allows you to choose a plan that contracts with your nursing home's pharmacy.
Get personal help to make decisions about your coverage.
How can I find a good nursing home?
Medicare.gov offers a Nursing Home Compare tool that you can use to find a nursing home in your area and compare quality ratings.