What Nursing Home Benefits Are Provided by Social Security?

Many people who receive Social Security benefits, including retirement benefits, disability benefits and Supplemental Security Income, also receive Medicare. Medicare provides limited nursing home benefits under specific circumstances. Some people receive Social Security benefits but not Medicare, and in those cases Social Security provides no nursing home benefits. Contact the Social Security Administration at 800-772-1213 or Medicare at 800-MEDICARE (800-633-4227) to find out if you qualify for nursing home benefits.

Short-Term Care

• Social Security only provides short-term nursing home benefits through the Medicare program. Medicare will pay a portion of the cost of nursing home care for up to 100 days, but patients who need long-term care must investigate other sources of payment, such as Medicaid or long-term care insurance (which you must purchase before you actually need it, of course, just like any other type of insurance).

Skilled Nursing Care

• Social Security only provides nursing home benefits if you require skilled nursing care. Skilled nursing care must be provided by professionals like licensed practical nurses, registered nurses, physical therapists and occupational therapists. It includes things like physical therapy, occupational therapy, complex dressing changes and the administration of intravenous drugs. You must need admission to a nursing home following an inpatient hospital stay of at least three days for Medicare to cover the cost. If you are admitted to a nursing home directly from your home or from an assisted living facility, Social Security will not provide any nursing home benefits for that admission.

What Is Not Covered

• Social Security does not provide benefits for custodial care. That means if you just need help with things like dressing, bathing, housekeeping and meals, Medicare will not pay for your care. However, if you must stay in a nursing home for skilled nursing care, you will also receive that kind of assistance at no extra charge.

Cost to Patient

• Most people who receive Social Security get Medicare Part A at no cost to them, which is the part of Medicare that covers nursing home care. Some people must pay monthly premiums for Medicare Part A, however. For the first 20 days you spend in a nursing home, Medicare Part A foots the entire bill. For the next 80 days, you have to pay $141.50 each day and Medicare pays the rest. If you continue to need nursing home care after 100 days, you are on your own. Social Security will not provide any further nursing home benefits.