# 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. - URL: https://explained.page/paying-for-a-nursing-home - Language: en - Last checked: 2026-10-29 - Watch the 1-minute animated guide: https://explained.page/watch?start=paying-for-a-nursing-home ## Step by step 1. **Who pays for a nursing home?** It’s one of the biggest costs families face. Here’s what Medicare covers, what it doesn’t, and where Medicaid comes in. 2. **Medicare covers short-term rehab only.** After a qualifying hospital stay, Medicare can cover skilled nursing care for up to 100 days, with a daily copay after day 20. It doesn’t pay for long-term custodial care. 3. **Medicaid pays for long-term care if you qualify.** It’s the biggest payer of nursing home care. Each state sets income and asset limits, and most of the person’s income goes toward the cost. 4. **Watch the 5-year look-back.** Medicaid reviews gifts and transfers made in the 5 years before applying. Giving away money or property can delay coverage. 5. **A spouse at home is protected.** Rules let the spouse who stays home keep some income and savings, so they aren’t left with nothing. 6. **Other ways to pay.** Savings, long-term care insurance, VA benefits for veterans and spouses, and in many states Medicaid programs that pay for care at home or in assisted living. 7. **Get advice early.** An elder law attorney can explain your state’s Medicaid rules and protect a spouse. Many areas have free help through the Area Agency on Aging. ## 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 ## 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. ## 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. Source page: https://explained.page/paying-for-a-nursing-home/questions/does-medicare-pay-for-assisted-living ### 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. Source page: https://explained.page/paying-for-a-nursing-home/questions/will-medicaid-take-the-house ### 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. Source page: https://explained.page/paying-for-a-nursing-home/questions/how-long-does-medicare-pay-for-a-nursing-home ### 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. Source page: https://explained.page/paying-for-a-nursing-home/questions/how-do-you-qualify-for-medicaid-nursing-home-care ### 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. Source page: https://explained.page/paying-for-a-nursing-home/questions/what-is-the-medicaid-5-year-look-back ### 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. Source page: https://explained.page/paying-for-a-nursing-home/questions/can-my-mom-keep-her-house-and-get-medicaid ### Does long-term care insurance cover nursing homes? Usually yes, depending on the policy’s benefits, waiting period and daily limits. Check the policy and file a claim early. Source page: https://explained.page/paying-for-a-nursing-home/questions/does-long-term-care-insurance-cover-nursing-homes ### What VA benefits help with nursing home costs? Eligible veterans and surviving spouses may qualify for VA nursing home care or a pension with Aid and Attendance. Contact the VA or an accredited representative. Source page: https://explained.page/paying-for-a-nursing-home/questions/what-va-benefits-help-with-nursing-home-costs ## Official sources - [Medicare.gov: skilled nursing facility care](https://www.medicare.gov/) - [Medicaid.gov: long-term services and supports](https://www.medicaid.gov/) - [VA: pension and aid for veterans](https://www.va.gov/) - [Eldercare Locator](https://eldercare.acl.gov/) To find your local office, search for: - "[your state] Medicaid long-term care application" - "[your county] Area Agency on Aging" --- General information, not legal or professional advice. Rules differ by state. From explained.page (www.explained.page). Life’s stuff, explained simply.