Questions & answers · Long-term care insurance
Does Medicare pay for a nursing home or long-term care?
Long-term care insuranceWho paysChecked Nov 6, 2026
From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-06 · Source: Medicare.gov · Medicare & You 2027 (official handbook PDF) · page 58 «What ISN'T covered by Part A and Part B?» View original ↗
In short
- Medicare does not pay for long-term help with daily living.
- It covers a short skilled nursing stay after 3+ days as a hospital inpatient.
- In 2026: days 1-20 cost $0, days 21-100 cost $217 a day.
What this means
Medicare and most health insurance, Medigap too, do not pay for long-term help with daily life. That means help with dressing, bathing, and using the bathroom, at home or in a nursing home [1]. You may get some of this from Medicaid if you qualify, or from long-term care insurance [1].
Medicare does pay for a short stay in a skilled nursing facility (SNF). First you need a hospital stay as an inpatient for 3 days in a row or more. Your doctor must also say you need skilled care every day [2]. In 2026, after the $1,736 deductible: days 1-20 cost $0, days 21-100 cost $217 a day, and you pay all costs from day 101 [2][3].
Original Medicare also does not pay for hearing aids, eye exams for glasses, routine checkups, or most dental care [1]. Some Medicare Advantage plans add vision, hearing, and dental benefits [1].
Your next step
If a family member is moving to a nursing home after a hospital stay, ask the hospital whether the stay was "inpatient" for 3 days in a row. For long-term custodial care, check Medicaid rules in your state. The sources give no deadline.
Check it yourself
Read pages 31 and 58 of Medicare & You. A Medicare Advantage plan may have different SNF costs — "Don't know yet" for your plan; check its Evidence of Coverage. The 2027 SNF amount — "Don't know yet" (not checked here).
Where this comes from (3)
[1] Medicare.gov · Medicare & You 2027 (official handbook PDF) · page 58 «What ISN'T covered by Part A and Part B?» · checked 2026-11-06
Medicare Advantage Plans and Medicare Cost Plans may cover some extra benefits, like fitness programs and vision, hearing, and dental services. Some of the items and services that Original Medicare doesn’t cover include: ✖ Non-medical long-term care. ✖ Eye exams (for prescription eyeglasses and corrected contact lenses). … ✖ Routine physical exams. ✖ Hearing aids and exams for fitting them. … Medicare and most health…
[2] Medicare.gov · Medicare & You 2027 (official handbook PDF) · page 31 «Skilled nursing facility care» · checked 2026-11-06
Medicare covers short-term, skilled nursing facility care when you have a qualifying inpatient hospital stay. This means you had a prior medically necessary inpatient hospital stay of 3 days in a row or more … To qualify for skilled nursing facility care, your doctor must certify that you need daily skilled care … • Days 1–20: You pay $0 each day after you pay the $1,736 amount. • Days 21–100: You pay $217 each day. …
[3] CMS · 2026 Medicare Parts A & B Premiums and Deductibles (fact sheet, Nov. 14, 2025) · page text · checked 2026-11-06
For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $217.00 in 2026 ($209.50 in 2025).
How we found this
We matched your question to 3 official sources, quoted the exact lines, and re-checked each quote against its source on 2026-11-06.
What we don’t know yet
Your own plan or notice may say something different. If your letter cites another rule, send it and we will look again.
Every answer is checked against the official rule it quotes.
Information only — not legal advice. Your plan, insurer or agency decides.
This answer quotes the official sources listed above, with the date we checked them. Your own policy, notice and state rules control. We are not your lawyer or your insurer. We don’t file, argue or negotiate claims for you — you send any letter or form yourself.
Related answers
- Who pays for long-term care like a nursing home or help with bathing and dressing — Medicare, Medicaid, or insurance?
- Who pays for an illness or injury — will my long-term care insurance cover it?
Answer id PQ1108. Spotted an error? Tell us.