What Medicare covers
Does Medicare cover long-term care? What it pays for, and what doesn't
Many people expect Medicare to pay for a nursing home or a home aide when they can no longer manage on their own. It usually doesn't. Here's the line between what Medicare covers and what it doesn't, and the programs that pay for long-term care instead.
Last reviewed October 27, 2026. General information, not advice about any plan.
What Medicare doesn't cover
Medicare doesn't cover custodial care if it's the only care you need. Custodial care is help with everyday activities like bathing, dressing, eating or using the bathroom, whether it's at home, in assisted living or in a nursing home.
- Not covered
- Long nursing home stays, assisted living, 24-hour care at home, homemaker services, and meal delivery.
- Medigap doesn't fill this gap
- Medigap and most health insurance don't pay for non-medical long-term care either.
What Medicare does cover
- Short stays in a skilled nursing facility
- Up to 100 days per benefit period, for daily skilled care after an inpatient hospital stay of at least 3 days in a row. In 2026, days 21 to 100 cost $217 a day. How it works.
- Home health care
- Part-time skilled nursing and therapy at home if you're homebound, including some aide help as part of that care. Who qualifies.
- Hospice
- Comfort care for a terminal illness, at home or in a facility, but generally not room and board in a nursing home. The hospice benefit.
- Some Medicare Advantage extras
- Some plans offer limited in-home support, adult day care or help for caregivers. These vary by plan and aren't long-term care coverage. Plans for people who live in nursing homes (institutional Special Needs Plans) coordinate their medical care.
Medicaid
Medicaid is the main payer for long-term care in the U.S. Unlike Medicare, it pays for custodial care in nursing homes, and some care at home or in the community. Each state runs its own program, and what's offered at home varies a lot.
- Who qualifies
- People with limited income and savings who also meet the state's test for needing long-term care. Rules and limits vary by state.
- Care at home
- States offer home and community-based services, often through waiver programs that may have waiting lists.
- Spending down
- In many states, people whose income is too high can qualify after spending enough on medical and care costs.
- The 5-year look-back
- Medicaid checks for money or property given away or sold for less than its value in the 5 years before you apply. Such transfers can delay coverage of long-term care.
- Estate recovery
- After the death of someone 55 or older, states must try to recover what Medicaid paid for long-term care, and related hospital and drug costs, from their estate, but not while a spouse, a child under 21, or a blind or disabled child survives. Hardship waivers exist.
Medicaid rules for long-term care are complex. An elder law attorney, or your state Medicaid office, can explain your state's rules.
PACE
The Program of All-Inclusive Care for the Elderly (PACE) helps people who need a nursing home level of care keep living at home. A team coordinates all your care, including doctor visits, drugs, home care, transportation, adult day care and nursing home stays when needed.
- Who can join
- People 55 or older who live in a PACE service area, are certified by the state as needing a nursing home level of care, and can live safely at home with PACE's help when they join.
- Cost
- No monthly premium with Medicaid. With Medicare but not Medicaid, a monthly premium for the long-term care part plus a drug premium. No deductibles or copays for care the team approves.
- Where
- About 200 programs in 33 states and Washington, D.C. (National PACE Association, a trade group, September 2026). Search Medicare.gov/pace.
- You get your care through PACE's own team and network. You can leave at any time, effective the first of the next month.
Other ways to pay
- Long-term care insurance
- Pays toward custodial care, at home or in a facility, usually up to a daily amount. Most policies require health questions, and premiums can rise. It's easier to get when you're younger and healthy.
- Partnership policies
- Some states offer qualified "Partnership" long-term care policies: if you later need Medicaid, in most of these states you can keep extra savings equal to what the policy paid out. Ask your state insurance department.
- Veterans' benefits
- VA health care can include nursing home care, home care and adult day care, depending on your needs, income and service-connected disability. VA doesn't pay rent in assisted living, but it may cover some care you get there. Aid and Attendance adds to a VA pension for people who need daily help.
- Your own savings
- Most people pay at least part of the cost themselves. A national survey put the median cost of a private nursing home room at $355 a day in 2025, and assisted living at $6,200 a month (CareScout, a private survey). Costs vary widely by area.
Where to get help
Eldercare Locator
Call 1-800-677-1116 or visit eldercare.acl.gov to find your Area Agency on Aging, which can help with meals, in-home help and local programs.Your state's SHIP
Free, unbiased help with Medicare and Medicaid questions. Your state's number is on its license-check page.Your state Medicaid office
To ask about long-term care coverage and how to apply.
A licensed agent can explain Medicare plan options, and some also sell long-term care insurance. Ask what they're licensed to sell before you meet.
Common questions
Does Medicare pay for a nursing home?
Not for long-term stays. Medicare covers up to 100 days in a skilled nursing facility for daily skilled care after a hospital stay of at least 3 days as an inpatient, but not care that's mainly help with daily activities. Medicaid is the main payer for long-term nursing home care.
Does Medicare pay for home health aides?
Only as part of covered home health care: you must be homebound and need part-time skilled care. Medicare doesn't pay for 24-hour care, or for help with bathing, dressing or housework when that's the only care you need.
Does Medigap cover long-term care?
No. Medigap and most health insurance don't pay for non-medical long-term care. Medicaid, long-term care insurance, PACE or veterans' benefits may.
What is the Medicaid look-back period?
Medicaid looks at money and property you gave away or sold for less than its value in the 5 years before you apply. Such transfers can delay Medicaid coverage of long-term care.
Keep reading
- Does Medicare cover nursing home care? Skilled nursing vs. long-term careMedicare covers short-term skilled nursing facility care after a qualifying hospital stay, up to 100 days, but not long-term nursing home care. The 3-day rule, 2026 costs, and what to do when coverage ends.
- Does Medicare cover home health care? Who qualifies and what's includedMedicare pays in full for part-time skilled care at home if you're homebound and need skilled nursing or therapy. What "homebound" means, what's covered and not, and what to do if an agency stops your care.
- Have Medicare and Medicaid? What changes, and how an agent can helpIf you qualify for both Medicare and Medicaid, you have extra help with costs, special plans, and more chances to change coverage. What to know, the 2025 rule changes, and what to watch for.
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