Long-term care
Medicare Coverage Information
Overview
Medicare provides limited coverage for long-term care, primarily focusing on short-term skilled nursing and rehabilitation services. Most custodial or ongoing personal care is not covered by Medicare, requiring beneficiaries to explore alternative funding options.
- Medicare covers short-term skilled nursing facility care after a qualifying hospital stay
- Limited home health services are covered for medically necessary care
- Does not cover long-term custodial care or extended personal assistance
- Typically covers up to 100 days of skilled nursing facility care
- Requires a qualifying 3-day hospital inpatient stay before nursing home coverage
- Medicare Part A beneficiaries
- Patients with qualifying medical conditions
- Individuals requiring skilled nursing or rehabilitation services
- Must have a preceding qualifying hospital stay
- No cost for first 20 days of skilled nursing facility care
- Beneficiary pays $204.50 per day for days 21-100 in skilled nursing facility
- 20% coinsurance for covered home health services
- Must meet Part A deductible for initial coverage period
- Must be medically necessary care
- Limited to short-term rehabilitation and recovery
- Does not cover long-term personal care or assistance with daily living
- Requires prior hospitalization for some services
- Coverage ends after 100 days of skilled nursing care
- Consult with healthcare provider about medical necessity
- Verify specific coverage details with your Medicare plan
- Consider supplemental long-term care insurance
- Contact Medicare at 1-800-MEDICARE for personalized guidance
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare long-term careskilled nursing coverageMedicare nursing homehome health servicesMedicare care limitations
Related Coverage Topics
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