Paying for a nursing home: Medicare, Medicaid and more
Medicare covers only short-term skilled nursing care after a qualifying hospital stay, up to 100 days with a daily copay after day 20; it doesn’t pay for long-term custodial care. Medicaid is the biggest payer of long-term care for people who meet their state’s income and asset limits. Medicaid reviews gifts and transfers made in the 5 years before applying, and spouses at home have protections. Other options include savings, long-term care insurance and VA benefits.
Your checklist
- Medicare: short-term rehab only
- Medicaid: long-term care if eligible
- Watch the 5-year look-back
- Know a spouse at home is protected
- Check insurance and VA benefits
- See an elder law attorney early
Rather read it? Here’s the whole thing.
What Medicare covers
After a qualifying inpatient hospital stay, Medicare can cover skilled nursing facility care for rehab, up to 100 days per benefit period: the first 20 days fully, then with a daily copay. Medicare doesn’t pay for long-term custodial care (help with bathing, dressing and daily living).
Medicaid
Medicaid is the largest payer of long-term nursing home care. Each state sets income and asset limits. Once eligible, most of the person’s income goes toward the cost, and Medicaid pays the rest.
The 5-year look-back
Medicaid reviews gifts and transfers made in the 5 years before applying. Giving away money or property can create a penalty period with no coverage. Get advice before transferring anything.
Spouses
When one spouse needs care, rules let the spouse at home keep some income and assets.
Other ways to pay
- Savings and income (private pay)
- Long-term care insurance
- VA benefits for veterans and surviving spouses
- In many states, Medicaid programs for care at home or in assisted living
Get help
An elder law attorney can explain your state’s rules. Your Area Agency on Aging offers free information.
Official sources, and where to look
- Medicare.gov: skilled nursing facility caremedicare.gov
- Medicaid.gov: long-term services and supportsmedicaid.gov
- VA: pension and aid for veteransva.gov
- Eldercare Locatoreldercare.acl.gov
[your state] Medicaid long-term care application[your county] Area Agency on Aging
Common questions
Does Medicare pay for assisted living?
No. Medicare doesn’t pay for assisted living room and board. Some state Medicaid programs help with assisted living services. More ›
Will Medicaid take the house?
Often the home isn’t counted while a spouse lives there. After death, states may try to recover costs from the estate. Rules vary; get advice. More ›
How long does Medicare pay for a nursing home?
Up to 100 days of skilled nursing care per benefit period after a qualifying hospital stay: days 1 to 20 fully covered, days 21 to 100 with a daily copay. It doesn’t cover long-term custodial care. More ›
How do you qualify for Medicaid nursing home care?
You must need nursing-home-level care and meet your state’s income and asset limits. Apply through your state Medicaid agency. More ›
What is the Medicaid 5-year look-back?
A review of gifts and transfers made in the 5 years before applying. Transfers for less than fair value can trigger a penalty period without coverage. More ›
Can my mom keep her house and get Medicaid?
Often the home isn’t counted while she, a spouse or certain relatives live there, up to state limits. Estate recovery may apply later. Get advice. More ›
Know someone who needs this?
Not yet reviewed by an expert. Last checked 2026-10-29. This is general help, not legal, medical or professional advice. Rules are different in every state.