Does Medicare Cover Long-Term Care? What Families Should Know

Many families ask “does Medicare cover long-term care?” when a parent needs help every day after a hospital stay. In short, Medicare pays for medical care, not for ongoing help with daily life. This guide explains what Medicare pays for in 2026 and where Californians can turn for the rest.

What counts as long-term care?

Long-term care is help with everyday tasks like bathing, dressing, eating and using the bathroom. Medicare calls these “activities of daily living,” and this help is also called custodial care.

Skilled care is medical care that nurses or therapists give or supervise, like wound care or physical therapy. Medicare pays for some skilled care. It doesn’t pay for custodial care when that’s the only care you need.

Type of care	Does Original Medicare pay?	Main conditions
Custodial care, at home or in a facility	No	You pay, unless Medi-Cal or insurance helps
Skilled nursing facility care	Yes, for a short stay	A qualifying hospital stay; up to 100 days per benefit period
Home health care	Yes	You’re homebound and need part-time skilled care
Hospice care	Yes	A life expectancy of 6 months or less

Does Medicare cover long-term care in a nursing home?

Not for a long stay. Medicare doesn’t pay for living in a nursing home for custodial care. It does pay for a short stay in a skilled nursing facility (SNF) while you need daily skilled care.

Medicare skilled nursing facility coverage: the rules

You must meet all of these conditions:

• You have Part A and days left in your benefit period.
• You had a qualifying inpatient hospital stay of at least 3 days in a row, not counting the day you leave.
• You enter the SNF soon after the hospital, generally within 30 days.
• Your doctor decides you need daily skilled care from nursing or therapy staff.
• The SNF is Medicare-certified, and the care is for a condition treated in the hospital (or one that started in the SNF).

If your doctor is part of an Accountable Care Organization (ACO) with a SNF 3-day rule waiver, you may not need the 3-day hospital stay. Ask your doctor or the hospital staff.

Time spent “under observation” or in the emergency room before you’re admitted doesn’t count toward the 3 days, even overnight. Ask the hospital each day whether you’re an inpatient or an outpatient.

What you pay for a SNF stay in 2026

• Days 1–20: $0 a day. The Part A deductible ($1,736 per benefit period in 2026) applies, but you usually paid it already during the hospital stay
• Days 21–100: $217 a day in 2026
• Day 101 and after: you pay all costs

A benefit period ends when you haven’t had inpatient hospital care or skilled SNF care for 60 days in a row. Coverage also ends if you no longer need daily skilled care. If it ends only because you aren’t improving, but you still need skilled care to keep from getting worse, you can appeal.

Most Medigap plans help with the daily SNF coinsurance. But Medigap generally doesn’t cover long-term care.

Medicare home health care: what’s covered?

Medicare pays for part-time or intermittent skilled nursing care or therapy at home if you’re homebound. A doctor or other provider must see you in person and order the care. A Medicare-certified home health agency must provide it, and you pay nothing for covered home health services. For Medicare-covered medical equipment, you generally pay 20% coinsurance after the Part B deductible.

Medicare doesn’t pay for:

• Care 24 hours a day
• Meals delivered to your home
• Shopping and cleaning that aren’t part of your care plan
• Personal care, like bathing or dressing, when that’s the only care you need

Hospice care, wherever you live

To get hospice, a hospice doctor and your regular doctor (if you have one) must certify that you’re terminally ill. That means a life expectancy of 6 months or less. You choose comfort care instead of care to cure the illness.

Hospice can usually come to you at home, in assisted living or in a nursing home, but Medicare doesn’t pay room and board there. If you’re in a Medicare Advantage plan, Original Medicare pays for your hospice care.

How Medicare Advantage plans handle long-term care

Medicare Advantage plans are offered by private companies that contract with Medicare. Like Original Medicare, they generally don’t pay for custodial care. For SNF stays, a plan:

• May charge copays during the first 20 days
• May waive the 3-day hospital stay
• May need to approve your stay first, and may require a SNF in its network

Some plans offer limited extra benefits, so check the plan’s Evidence of Coverage.

Medi-Cal long-term care in California

Medi-Cal, California’s Medicaid program, can pay for nursing home care and some help at home for people who qualify. If the answer to “does Medicare cover long-term care?” is no for your family, Medi-Cal is often the next place to look.

The asset limit and the July 2027 drop

Since January 1, 2026, Medi-Cal has an asset limit again for most people 65 and older, including for long-term care:

• January 1, 2026 – June 30, 2027: $130,000 for one person, plus $65,000 for each additional person
• From July 1, 2027: $21,000 for one person and $31,000 for two, plus $1,550 for each additional person

Your main home and main vehicle generally aren’t counted. If you move into a nursing home, your home still isn’t counted if you plan to return to it, or if your spouse or a dependent relative lives there. See our guide to the Medi-Cal asset limit for 2026.

Gifts, income and spouses

For nursing home care, Medi-Cal looks at assets you gave away in the 30 months before you entered the facility. The state says transfers before January 1, 2026 aren’t counted, but later ones may cause a penalty that delays coverage. Get advice from your county office or an elder-law attorney first.

If you’re single, most of your monthly income generally goes toward your nursing home care. You keep a small amount for personal needs. If one spouse needs nursing home care, special rules protect some income and assets for the spouse at home.

Help at home through Medi-Cal

• In-Home Supportive Services (IHSS): help with personal care, housework, meals, laundry, shopping and going with you to medical appointments, for older adults and people with disabilities. Apply through your county IHSS office.
• Multipurpose Senior Services Program (MSSP): care management, where it’s offered, for Medi-Cal members age 60 or older who are certifiable for nursing facility care but want to stay home.

With both Medicare and full Medi-Cal, you may be able to join a Medi-Medi Plan, if one is offered in your county, to coordinate the two programs.

PACE: another way to get care at home

PACE is a Medicare and Medi-Cal program for people 55 or older who live in a PACE service area. The state must certify that you need a nursing home level of care. When you join, you must be able to live safely in the community with PACE’s help.

One care team arranges your care, including nursing home stays it approves. Medicare.gov says that if you have Medicaid (Medi-Cal in California), you won’t pay a monthly premium for the PACE benefit. See our guide to PACE in California.

Long-term care insurance: what to compare

Long-term care insurance is private coverage that can help pay for care at home, in assisted living or in a nursing home. What it pays depends on the policy. Before you buy, compare:

• The kinds of care and settings it covers
• The daily or monthly benefit, and how long benefits last
• The waiting period before benefits start
• Inflation protection, and whether premiums can rise later

Insurers usually ask about your health before they sell a policy. HICAP counsels people on long-term care insurance, and the California Department of Insurance publishes a yearly rate guide.

How to plan for long-term care

1. Talk with your family about where you’d want care and who can help.
2. Check the Medi-Cal rules early, including the July 1, 2027 drop, before you move or give away assets.
3. Ask about ways to stay at home, like PACE, IHSS and MSSP.
4. Compare long-term care insurance if it fits your health and budget.
5. Get help. HICAP (1-800-434-0222) offers one-on-one counseling, and the Eldercare Locator (1-800-677-1116) can find local services. Veterans may get some care through VA; see Medicare and VA benefits.

Frequently asked questions

Does Medicare cover nursing home care?

Medicare covers short SNF stays for daily skilled care after a qualifying hospital stay, up to 100 days per benefit period. It can also cover hospice care in a nursing home, but not room and board. It doesn’t pay for living in a nursing home for custodial care.

Does Medicare pay for assisted living?

No. Medicare doesn’t pay for room and board or personal care in assisted living. It still covers your doctor visits and other covered care, and hospice can be provided there.

What happens when Medicare stops paying for a SNF stay?

You pay the full cost unless Medi-Cal, insurance or another program pays. If you think coverage is ending too early, you can appeal. Ask the facility’s social worker about Medi-Cal and other options.

Talk with a licensed Boomers agent

A licensed Boomers agent can go over the Medicare plans we represent in your area and check them against your doctors and prescriptions. We can also explain how each plan handles skilled nursing and home health care.

Find a licensed agent near you · See upcoming Medicare events

Or call 1-800-815-1943 (TTY 711), Monday – Friday, 9 AM – 5 PM Pacific.

Sources

• Long-term care (Medicare.gov)
• Skilled nursing facility care (Medicare.gov)
• Home health services (Medicare.gov)
• Hospice care (Medicare.gov)
• Medicare & You 2027 handbook (Medicare.gov)
• 2026 Medicare Parts A & B Premiums and Deductibles (CMS)
• Asset limit frequently asked questions (California Department of Health Care Services)
• In-Home Supportive Services (California Department of Social Services)
• Multipurpose Senior Services Program (California Department of Aging)
• Medicare Counseling (HICAP) (California Department of Aging)
• Long-term care insurance rate guide (California Department of Insurance)
• Long-term care (VA.gov)