Does Medicare Cover Long-Term Care?

Medicare Part A covers skilled nursing facility (SNF) care, but only under specific conditions and for a limited time. To qualify, you must first have a qualifying hospital inpatient stay of at least three consecutive days. After that, Medicare covers up to 100 days of skilled nursing care per benefit period.

Days 1–20 are covered in full. Days 21–100 require a $217 daily coinsurance in 2026. After day 100, you pay 100% of all costs. This benefit exists for rehabilitation and recovery - not permanent residence. Once your condition stabilizes or your recovery plateaus, coverage can end well before day 100.

Medicare does not cover custodial care under any circumstances. Even if you are still recovering from an illness or injury, once your primary need shifts to personal assistance rather than skilled treatment, Medicare stops paying.

Some Medicare Advantage plans offer supplemental benefits that go beyond Original Medicare - things like limited home health aide visits, meal delivery, or personal care services. These extras can be helpful, but they are not a substitute for dedicated long-term care coverage.

Whether you have Original Medicare or a Medicare Advantage plan, the fundamental rule remains: neither is designed to cover ongoing custodial care. In 2026, Medicare Advantage plans carry a maximum out-of-pocket limit of $9,250 for covered services - but that cap does not apply to long-term custodial care, which typically falls outside covered benefits entirely.

Before enrolling in any plan, carefully review the Evidence of Coverage document to understand exactly what long-term care-related benefits are included and what their limits are.

Medigap plans are designed to cover cost-sharing for services that Original Medicare covers - deductibles, coinsurance, and copayments. Since Medicare does not cover custodial long-term care, no Medigap plan will pay for it regardless of the plan letter.

Medigap can help reduce your out-of-pocket costs during a covered SNF stay (for example, covering the $217 daily coinsurance for days 21–100), but it provides no protection against the cost of ongoing custodial care after Medicare coverage ends.

When Medicare runs out, Medicaid becomes the primary public safety net for long-term custodial care. Nationally, Medicaid covers roughly 42% of all long-term care spending - far more than Medicare. It pays for nursing home care, home- and community-based services, and in some states, assisted living.

The catch is eligibility. Medicaid requires you to meet strict income and asset thresholds that vary by state. Many people must spend down their savings and assets before qualifying. A married couple may retain a protected amount for the community spouse, but the rules are complex and differ significantly by state.

Many people assume Medicare will protect them from catastrophic care costs. In reality, Medicaid functions as a payer of last resort - after your personal resources are largely exhausted. Understanding this distinction early gives you time to plan proactively rather than scrambling during a care crisis.