What Does Medicare Cover for Nursing Homes?

Medicare has limitations on what costs it will pay for when a patient enters a nursing home. It does not pay for long-term care in a nursing home, but it will pay for care in a skilled nursing facility.

Medicare

• Medicare provides health insurance coverage to individuals age 65 or older or individuals who have specific disabilities. Medicare defines a nursing home as a place where the care provided helps a patient with daily activities like bathing, dressing and eating.

   

Skilled Nursing Facility

• A skilled nursing facility provides care for a patient in need of rehabilitation services for a short period of time. The types of services provided are physical therapy, observation and evaluation of a patient's care. To have the services paid for, placement must be in a Medicare-certified facility and the patient must have been in the hospital for 3 days prior to being placed in the facility. There is a 100-day limit for a stay in a skilled nursing facility.

Additional Options

• A patient can be eligible for Medicaid to pay for care in a nursing home. He can also use long-term care insurance, Medigap and managed care plans to pay for nursing home services.