Medicare questions, answered
Does Medicare cover nursing homes or in-home care?
Medicare pays for some skilled care for a limited time. It does not pay for long-term care.
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By Christian Brinkley, Licensed Insurance Agent, Greensboro, NC. Updated October 1, 2026.
Families usually ask this at a hard moment: a parent is in the hospital, and someone has to figure out what comes next. The short answer surprises many people. Medicare covers limited skilled care, and it does not cover long-term custodial care. This is general education, not advice for your situation.
Skilled care versus custodial care
Skilled care is nursing or therapy that has to be done by trained professionals, like wound care or physical therapy after a hospital stay. Medicare can pay for some of that.
Custodial care is help with daily living, like bathing, dressing, eating, and getting around. Most long stays in a nursing home are for custodial care. Medicare does not pay for custodial care when it is the only care you need.
Skilled nursing facility coverage
Medicare Part A can cover a stay in a skilled nursing facility, but only if all of these are true:
- You had a medically necessary inpatient hospital stay of at least 3 days in a row. Time in the emergency room or under observation does not count.
- You enter the facility within a short time after leaving the hospital, generally 30 days.
- You need daily skilled care from nursing or therapy staff.
If you qualify, the 2026 costs for each benefit period work like this. For days 1 to 20, you pay $0 after your Part A deductible of $1,736. For days 21 to 100, you pay $217 per day. After day 100, Medicare pays nothing toward the stay. The deductible is not charged again if you already paid it for the same hospital stay.
If you have a Medicare Advantage plan, the plan sets its own costs and rules for these stays. Ask the plan before a move, not after.
Home health care
Medicare can pay for home health when a doctor orders it and you are homebound. Homebound means leaving home is hard for you, or needs help from a person or a device like a walker or wheelchair. The care has to come from a Medicare-certified agency.
What Medicare can cover:
- Part-time or occasional skilled nursing care.
- Physical, occupational, and speech therapy.
- Medical social services.
- A home health aide, but only alongside skilled nursing or therapy.
What Medicare does not cover:
- Care around the clock at home.
- Meal delivery.
- Homemaker help like shopping and cleaning.
- Personal care, when that is the only care you need.
What does pay for long-term care
Families usually rely on a mix of these:
- Personal savings and income.
- Long-term care insurance, if someone bought it before the need. Here is how that works.
- Medicaid, which has income and asset limits set by the state. NC Medicaid can explain who qualifies. I do not give advice on qualifying.
Why this matters before a crisis
The best time to understand this is while everyone is healthy. Once a parent is in the hospital, decisions come fast and the 3-day and 30-day rules start to matter right away. A calm conversation now gives a family time to ask questions and decide what they want.
If you are helping a parent, you may also find our page on helping a parent with Medicare useful.
Questions people ask me about this
- Does Medicare cover nursing homes or in-home care?
- Medicare covers limited skilled care in a nursing facility after a qualifying hospital stay, and part-time skilled home health care when a doctor orders it. It does not pay for long-term custodial care.
- How many nursing home days does Medicare cover?
- Up to 100 days in each benefit period, after a qualifying 3-day hospital stay. In 2026 you pay $0 for days 1 to 20 after the Part A deductible, and $217 per day for days 21 to 100.
- Does Medicare pay for 24-hour home care?
- No. Medicare home health is part-time or occasional. Medicare does not cover care around the clock at home.
Talk it through with a local agent, free: request a time at christianbrinkleync.com/start or call/text (919) 408-6671.
Sources
- Medicare.gov: Skilled nursing facility (SNF) care
- Medicare.gov: Home health services
- CMS: 2026 Medicare Parts A and B premiums and deductibles