Supplemental

Does Medicare Cover Long-Term Care? What Seniors Need to Know

Medicare covers only limited skilled nursing care, not long-term custodial care. Learn what Medicare pays for, the gaps, and how to fill them.

January 25, 2026

One of the most common misconceptions among seniors is that Medicare will cover their long-term care needs. The reality is that Medicare provides only very limited coverage for skilled nursing care and does not cover the custodial care that most people need as they age. According to the Administration for Community Living, approximately 56 percent of Americans turning 65 today will need some form of long-term care during their lifetime. Understanding exactly what Medicare does and does not cover is critical for planning ahead and avoiding a costly surprise.

What Medicare Covers: Skilled Nursing Facility Care

Medicare Part A covers up to 100 days of care in a skilled nursing facility (SNF) per benefit period, but only when specific conditions are met. This is the most significant long-term care benefit Medicare offers, and it comes with important limitations.

To qualify for Medicare-covered skilled nursing facility care, you must meet all of the following requirements:

You had a qualifying inpatient hospital stay of at least three consecutive days (not counting the day of discharge).
You enter the skilled nursing facility within 30 days of your hospital discharge.
You need daily skilled care, such as skilled nursing services or physical, occupational, or speech therapy.
The skilled nursing facility is Medicare-certified.

When you meet these requirements, Medicare covers skilled nursing facility care according to the following cost structure for 2026:

Days 1 through 20: Medicare pays the full approved cost. You pay $0 coinsurance.
Days 21 through 100: You pay a daily coinsurance of $204.50 per day in 2026. Over 80 days, this adds up to $16,360 in out-of-pocket costs.
After day 100: Medicare coverage ends completely. You are responsible for 100 percent of the cost.

It is important to note that many people do not use all 100 days. Medicare can stop coverage at any time if the facility determines you no longer need daily skilled care, even if you have not reached the 100-day limit.

What Medicare Covers: Home Health Care

Medicare also covers home health care services under certain conditions. Unlike skilled nursing facility care, home health care does not require a prior hospital stay. However, the coverage is limited to skilled care needs and has strict eligibility requirements.

To qualify for Medicare-covered home health care, you must:

Be homebound, meaning leaving home requires a taxing effort due to your medical condition
Need intermittent skilled nursing care, physical therapy, speech-language pathology services, or continued occupational therapy
Have a doctor order and regularly review a plan of care for you
Receive care from a Medicare-certified home health agency

When you qualify, Medicare covers skilled nursing visits, physical and occupational therapy, speech therapy, medical social services, some medical supplies, and limited home health aide services that are part of your skilled care plan. Medicare does not cover 24-hour home care, meal delivery, homemaker services like cleaning or laundry, or personal care assistance if that is the only care you need.

What Medicare Does Not Cover: The Long-Term Care Gap

The most critical thing to understand is what Medicare does not cover. Medicare was never designed to be a long-term care program. It is a health insurance program that covers acute medical care. The types of long-term care that most people need as they age fall outside of Medicare's scope.

Medicare does not cover:

Custodial care: Help with activities of daily living like bathing, dressing, eating, transferring, and toileting when skilled care is not also needed
Assisted living: The room, board, and personal care services provided in assisted living facilities
Long-term nursing home stays: Any nursing home care beyond 100 days, and all nursing home care that is purely custodial
Most home care: Personal care assistance, homemaker services, and 24-hour supervision in the home
Adult day care: Supervised programs that provide activities, meals, and monitoring during daytime hours

This gap between what people expect Medicare to cover and what it actually covers can be financially devastating. With nursing home costs averaging over $131,000 per year for a private room and the average length of a nursing home stay being 2 to 3 years, an unplanned long-term care need can quickly deplete a lifetime of savings.

How to Fill the Medicare Long-Term Care Gap

Since Medicare leaves such a significant gap in long-term care coverage, it is important to explore other options for covering these costs. Here are the most common ways to fill the gap.

Long-Term Care Insurance

Private long-term care insurance is specifically designed to cover the services that Medicare does not. A good LTC insurance policy can pay for nursing home care, assisted living, in-home care, and adult day care for a defined benefit period. The best time to purchase a policy is while you are still healthy, typically in your mid-50s to early 60s.

Medicaid

Medicaid is the largest single payer of long-term care in the United States and covers nursing home care for people who meet strict financial eligibility requirements. To qualify, you generally must have countable assets of $2,000 or less. This means most people must spend down their savings before Medicaid will begin paying for their care.

Hybrid Life Insurance and LTC Policies

Hybrid policies combine life insurance with long-term care benefits. If you need long-term care, the policy pays for it. If you never need care, your beneficiaries receive a death benefit. These products have grown in popularity because they address the concern many people have about paying for long-term care insurance they may never use.

Veterans Benefits

Veterans and their surviving spouses may qualify for long-term care benefits through the Department of Veterans Affairs. The VA provides nursing home care, home-based primary care, adult day health care, and the Aid and Attendance pension benefit, which provides monthly payments to help cover the cost of care. Eligibility is based on military service history, disability status, and income.

Common Misconceptions About Medicare and Long-Term Care

Several persistent misconceptions lead people to believe they have more coverage than they actually do. Understanding these misconceptions can help you avoid being caught off guard.

Misconception: Medicare covers nursing home stays indefinitely. Reality: Medicare covers a maximum of 100 days of skilled nursing care per benefit period, and only after a qualifying hospital stay. Most long-term nursing home residents have stays far exceeding 100 days.
Misconception: Medicare Supplement (Medigap) plans cover long-term care. Reality: Medigap plans only cover cost-sharing for services that Medicare already covers. Since Medicare does not cover custodial long-term care, Medigap does not either. Some Medigap plans do cover the skilled nursing facility coinsurance for days 21 through 100.
Misconception: Medicare Advantage plans provide extra long-term care coverage. Reality: While some Medicare Advantage plans offer limited supplemental benefits like short-term personal care or caregiver support, these benefits are not a substitute for comprehensive long-term care coverage.
Misconception: You will not need long-term care. Reality: The ACL estimates that 56 percent of people turning 65 will need some form of long-term care. Women need care for an average of 3.2 years, and men for an average of 2.3 years.

Understanding Medicare Costs for Skilled Nursing Care

Even the limited skilled nursing coverage that Medicare provides comes with significant costs. Understanding these costs can help you budget and plan. For a complete breakdown of all Medicare costs, see our guide on how much Medicare costs in 2026.

For a 100-day skilled nursing stay in 2026, your out-of-pocket costs under Original Medicare would include $0 for days 1 through 20 and $204.50 per day for days 21 through 100, totaling up to $16,360 in coinsurance. If you have a Medigap plan that covers skilled nursing facility coinsurance (such as Plan G or Plan N), this coinsurance would be covered by your supplement plan.

Planning Ahead: Your Next Steps

The best time to plan for long-term care is before you need it. Here are steps you can take now to prepare for the gap that Medicare leaves:

Understand your risk: With a 56 percent chance of needing long-term care after 65, the odds favor planning rather than hoping for the best.
Research costs in your area: Long-term care costs vary significantly by location. See our guide on how much long-term care costs in 2026 for detailed cost breakdowns.
Evaluate your coverage options: Consider long-term care insurance, hybrid policies, and savings strategies. Each approach has pros and cons depending on your financial situation.
Talk to your family: Discuss your preferences for where and how you would like to receive care. These conversations are difficult but essential.
Consult a professional: A financial advisor who specializes in retirement planning can help you evaluate your options and create a comprehensive plan.

Medicare is an excellent program for covering medical care, but it was never intended to serve as a long-term care plan. Recognizing this limitation and taking steps to fill the gap is one of the most important things you can do to protect your financial security in retirement.

Many seniors are surprised to learn about these limitations only after they or a family member already needs long-term care. At that point, options become much more limited. People who wait until a health crisis to explore their coverage often find themselves paying out of pocket for expensive care they assumed would be covered. By educating yourself now about what Medicare does and does not cover, you are already ahead of the majority of Americans who have not yet considered how they will pay for long-term care.

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Frequently Asked Questions

How many days of nursing home care does Medicare cover?

Medicare covers up to 100 days of skilled nursing facility care per benefit period, but only if you meet specific requirements. You must have had a qualifying inpatient hospital stay of at least three consecutive days, and you must need skilled nursing or therapy services. For days 1 through 20, Medicare pays the full cost with no coinsurance. For days 21 through 100, you pay a daily coinsurance of $204.50 in 2026. After day 100, Medicare pays nothing and you are responsible for the full cost.

What is the difference between skilled care and custodial care?

Skilled care involves medical services that must be performed by licensed medical professionals, such as registered nurses, physical therapists, occupational therapists, or speech therapists. Examples include wound care, IV therapy, injections, and physical rehabilitation. Custodial care involves non-medical assistance with everyday activities like bathing, dressing, eating, toileting, and moving around. Medicare covers skilled care in certain settings but does not cover custodial care. Most long-term care is custodial in nature, which is why Medicare does not cover the majority of long-term care needs.

Does Medicare cover assisted living?

No, Medicare does not cover assisted living facility costs. Assisted living provides personal care assistance and supervision, which is considered custodial care. Medicare only covers skilled medical care in approved settings. If you live in an assisted living facility, Medicare may still cover individual medical services you receive, such as doctor visits or outpatient therapy, but it will not cover the room, board, or personal care services that make up the bulk of assisted living costs.

Does Medicare cover home health care?

Medicare covers home health care only when you meet specific conditions. You must be homebound, meaning leaving home requires considerable effort. You must need intermittent skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy. A doctor must order and regularly review a plan of care for you. Under these conditions, Medicare covers skilled nursing visits, therapy, medical social services, some medical supplies, and limited home health aide services. However, Medicare does not cover 24-hour home care, meals delivered to your home, homemaker services, or personal care when that is the only care you need.

Does Medicare Advantage cover long-term care?

Medicare Advantage plans must cover at least the same services as Original Medicare, which means they also cover up to 100 days of skilled nursing facility care and limited home health care under the same rules. Some Medicare Advantage plans offer additional supplemental benefits that may include limited personal care, caregiver support, or adult day care services. However, these extra benefits are generally limited in scope and duration, and no Medicare Advantage plan covers comprehensive long-term custodial care.

How can I pay for long-term care if Medicare does not cover it?

There are several ways to pay for long-term care beyond Medicare. Long-term care insurance is specifically designed to cover these costs and should be purchased while you are still healthy, ideally in your 50s or early 60s. Medicaid covers long-term care for people who meet strict financial requirements, which typically means spending down most of your assets first. Hybrid life insurance and long-term care policies provide LTC benefits if needed or a death benefit if not. Some veterans qualify for VA long-term care benefits. Personal savings, home equity, and retirement accounts are also commonly used to fund care.

Medicarelong-term carenursing homeskilled nursingMedicare coverage gapsLTC insuranceseniors