Medicare vs Medicaid for nursing home care (United States)
Most US families assume Medicare pays for nursing home care. It rarely does. Medicaid pays for the majority of long-term nursing home stays in the United States. This guide explains the difference, what each program covers, and how to plan for the gap.
What Medicare covers
Original Medicare (Parts A and B) pays for up to 100 days of skilled nursing facility (SNF) care per benefit period — but only after a qualifying 3-day inpatient hospital stay, and only if you need daily skilled care (such as IV antibiotics or rehab). Days 1–20 are fully covered; days 21–100 require a daily co-pay (around $204 per day in 2025). After 100 days, Medicare pays nothing.
What Medicare does NOT cover
Custodial care — help with bathing, dressing, eating and moving — is not covered by Medicare, even though it is the main service most nursing home residents need. Long-term stays beyond 100 days are not covered. Room and board in assisted living is not covered.
What Medicaid covers
Medicaid is the largest single payer of long-term nursing home care in the US. Once you qualify, Medicaid covers room, board, and custodial care indefinitely in any Medicaid-certified nursing home. Around 62% of US nursing home residents are on Medicaid.
Medicaid eligibility
Medicaid is means-tested. In most states, an individual applicant must have monthly income below roughly $2,900 (2025) and countable assets under $2,000. Your home, one car, and personal belongings are usually exempt. Income and asset rules differ by state — check your state's Medicaid agency.
The 5-year look-back
Medicaid reviews asset transfers in the 5 years before your application. Gifts or below-market transfers can trigger a penalty period during which Medicaid will not pay. Plan early with an elder-law attorney if asset protection matters to you.
What about Medicare Advantage?
Medicare Advantage (Part C) plans must cover at least the same SNF benefits as Original Medicare, but networks and prior-authorisation rules vary. Some plans add extra benefits (transportation, meals). None turn Medicare into long-term-care coverage.
Frequently asked questions
Authoritative sources
The figures and rules in this guide are drawn from the following official and independent sources. Open any link to verify the latest published numbers.
- Skilled nursing facility (SNF) care coverage
Medicare.gov
- Medicaid Long Term Services and Supports
Medicaid.gov
- Long-Term Care Services in the United States: 2024 Overview
KFF (Kaiser Family Foundation)
- Medicare & You handbook
CMS.gov
About this guide
Written and reviewed by the Nursing Home Match editorial team. We update guides at least annually and verify every figure against the official sources listed above. This guide is general information, not personal, medical, financial or legal advice. Always confirm details on Medicare.gov Care Compare (United States) or My Aged Care (Australia), or speak to a qualified adviser before making decisions.