Medicare generally doesn't cover long-term care stays in a nursing home. Even if Medicare doesn’t cover your nursing home care, you’ll still need Medicare for hospital care, doctor services, and medical supplies while you’re in the nursing home. Find out what nursing home care Medicare does cover, and how Medicare prescription drug coverage (Part D) works if you live in a nursing home or other institution.
Most people who enter nursing homes start by paying for their care out-of-pocket.
There are several other ways you can pay for nursing home care:
Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Most health care costs are covered if you qualify for both Medicare and Medicaid. Most, but not all, nursing homes accept Medicaid payment. Even if you pay out-of-pocket or with long-term care insurance, you may eventually "spend down" your assets while you’re at the nursing home, so it’s good to know if the nursing home you chose will accept Medicaid.
Medicaid programs vary from state to state. Most often, eligibility is based on your income and personal resources. Many states have higher Medicaid income limits for nursing home residents. You may be eligible for Medicaid coverage in a nursing home even if you haven’t qualified for other Medicaid services in the past.
To get more information on Medicaid eligibility in your state, call your state Medicaid office.
Long-term care insurance
This type of insurance policy can help pay for many types of long-term care, including both skilled and non-skilled care. Long-term care insurance can vary widely. Some policies may cover only nursing home care, while others may include coverage for a range of services, like adult day care, assisted living, medical equipment, and informal home care.
If you have long-term care insurance, check your policy or call the insurance company to find out if the care you need is covered. If you're shopping for long-term care insurance, find out which types of long-term care services and facilities the different policies cover. Also, check to see if your coverage could be limited because of a pre-existing condition . Make sure you buy from a reliable company that's licensed in your state.
Federal employees, members of the uniformed services, retirees, their spouses, and other qualified relatives may be able to buy long-term care insurance at discounted group rates. Get more information about long-term care insurance for federal employees.
You can use your personal money and savings to pay for nursing home care. Some insurance companies let you use your life insurance policy to pay for long-term care. Contact your insurance provider for more information on what your private insurance covers.