Nursing home care
Medicare doesn't cover custodial care if it's the only care you need
Description
Most nursing home care is custodial care, which helps you with activities of daily living (like bathing, dressing, using the bathroom, and eating) or personal needs that could be done safely and reasonably without professional skills or training.
Coverage details
Medicare Part A (Hospital Insurance) may cover skilled nursing care in a nursing home. It must be medically necessary for you to get skilled nursing care (like if you need help changing sterile dressings).
If you're in a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan, check with your plan to see if it covers nursing home care. Usually, plans don't help pay for this care unless the nursing home has a contract with the plan. Ask your plan about nursing home coverage and check the facility’s quality ratings before you make any arrangements to enter a nursing home.
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service