Health care & prescriptions in a nursing home

Depending on what kind of coverage you have, Medicare may pay for your health care and prescription drugs while you're in a nursing home.

Medicare covers nursing home care in 2 ways:

  1. Original Medicare
      doesn't pay for most nursing home care. Most nursing home care helps with . Medicare covers very limited and skilled care at a nursing home or in your home (with home health care) if you need short-term skilled care for an illness or injury and you meet certain conditions.
  2. Medicare Advantage Plans and other Medicare health plans
    If you're in a (like an HMO or PPO) or other , 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 before you make any arrangements to enter a nursing home. If the nursing home has a contract with your health plan, ask the health plan if they check the home for quality of care.

Medicare prescription drug coverage (Part D)

If you have 

 and live in a nursing home or other institution, you’ll get your covered prescriptions from a long-term care pharmacy that works with your plan.

Learn more about your drug coverage if you have full coverage from Medicaid and live in a nursing home.

If you have Medicare & live in a nursing home or other institution, you should know:

  • If you move in or out of a nursing home or other institution, you can switch Medicare drug plans at that time.
  • You can switch Medicare drug plans at any time while you’re living in the institution.
  • If you aren't able to join a drug plan on your own, your authorized representative can enroll you in a plan that meets your needs.
  • If you're in a skilled nursing facility (SNF) getting Medicare-covered , your prescriptions generally will be covered by Part A.