Making the decision to move yourself or a loved one into a nursing home can be overwhelming. It’s important to understand the financial side of things before making the move. One option for coverage is Medicare, a federal health insurance program for those who are 65 or older, younger people with certain disabilities, and people with End-Stage Renal Disease (ESRD). In this article, we’ll explore what you need to know about Medicare benefits for nursing home care.

Understanding Medicare Coverage for Nursing Home Care

Medicare offers coverage for skilled nursing home care, which is provided by a licensed nurse or therapist. This coverage is only available for a limited time and only under certain conditions. In order for Medicare to cover nursing home care, it must be deemed medically necessary and recommended by a doctor. The care must also be provided in a Medicare-certified skilled nursing facility.

Medicare will typically cover the first 20 days of nursing care in full. From days 21-100, a co-payment will be required. After day 100, Medicare will no longer cover the cost of nursing care. It’s important to note that Medicare only covers skilled care, not custodial care, which includes assistance with activities of daily living such as bathing, dressing, and eating.

Navigating the Medicare System

Navigating the Medicare system can be confusing, especially when it comes to nursing home care. It’s important to know that you have options when it comes to selecting a nursing home. Not all nursing homes accept Medicare, so it’s important to research the facilities in your area to find one that does. The official Medicare website has a tool that allows you to search for Medicare-certified nursing homes in your area.

Once you’ve selected a nursing home, it’s important to speak with the admissions office to determine if we accept Medicare and if we have any additional requirements. The nursing home will also be able to assist you in determining if you meet the medical requirements for Medicare coverage of nursing care.

It’s also important to keep in mind that Medicare is not the only option for coverage of nursing care. Medicaid is another option for those who meet certain income and asset requirements. Private insurance may also offer coverage for nursing home care, although it’s important to check the specifics of your policy.

Cost of Nursing Home Care

The cost of nursing home care can be expensive. According to a 2020 survey by Genworth Financial, the average cost of a semi-private room in a nursing home is $7,756 per month. The cost of a private room is even higher at $8,821 per month. Medicare will cover some of the costs of Medicare and nursing care, but it’s important to be prepared for additional costs.

Financial Planning

It’s important to plan ahead financially when it comes to nursing home care. Long-term care insurance is one option for coverage, although it can be expensive. Another option is to set up a trust or use other estate planning strategies to protect assets and ensure that we are used to paying for nursing home care.

Finding Additional Resources

Navigating the world of nursing care and Medicare coverage can be overwhelming. It’s important to know that there are resources available to help you through the process. The National Council on Aging offers a free online tool called BenefitsCheckUp that can help you determine what benefits you may be eligible for. The tool includes information on Medicare, Medicaid, and other programs that offer assistance with healthcare costs.

Suncrest Hospice Care is another resource that can help you navigate the world of Medicare and nursing home care. We offer hospice care and palliative care services to those who are nearing the end of life.


Navigating the world of Medicare and nursing care can be overwhelming, but it’s important to understand your options and plan ahead. Medicare offers coverage for nursing care, but it’s important to be aware of the limitations and additional costs. It’s also important to research nursing homes in your area to find one that accepts Medicare and meets your needs.

We understand the challenges of nursing home care and are here to offer support and guidance. Our team of healthcare professionals can help you navigate the Medicare system and find additional resources to make the transition to nursing care as smooth as possible. Contact us today to learn more about our hospice and palliative care services and how we can support you and your loved ones.