Does Medicare Cover Me If I Am In A Nursing Home

Medicare-Covered Services in a Nursing Home

✅ Skilled Nursing Facility (SNF) Care (Short-Term Only)

• If you have a qualifying hospital stay (at least 3 days inpatient)
• Covers rehabilitation, skilled nursing care, and medical treatments
• Medicare Part A pays 100% for the first 20 days, then you pay a copay ($209.50/day in 2025) for days 21-100
• After 100 days, you must pay all costs

✅ Medical Services While in a Nursing Home (Regardless of Length of Stay)

• Doctor visits, physical/occupational therapy, and medications (if on Part D)
• Some preventive screenings and medical equipment

What Medicare Does NOT Cover in a Nursing Home

❌ Long-term custodial care (help with daily living activities)
❌ Room and board costs for non-skilled care
❌ Private rooms (unless medically necessary)

Who Pays for Long-Term Care?

• Medicaid(if you meet low-income and asset requirements)
• Long-term care insurance
• Out-of-pocket payments

 

In 2025, the Medicare Skilled Nursing Facility (SNF) care costs are:

• Days 1–20:$0 per day (fully covered by Medicare Part A).
• Days 21–100:$209.50 per day (you pay this coinsurance amount).
• Days 101 and beyond:You pay all costs (Medicare does not cover long-term care).

These costs applied per benefit period, which resets after 60 consecutive days without inpatient care.