Does Medicare Cover the Cost of Nursing Homes?

Posted by Melissa Hanes
Estimated Reading Time 1 minute 29 seconds

Medicare beneficiaries often make the mistake of assuming the program will always pay for any type of medical services that they need. But when it comes to nursing home stays, which can be lengthy and expensive, you might be surprised to learn that traditional Medicare does not offer coverage for this service. In the event that you need a nursing home at some point, you will need to pay for your stay in some other way.

Essentially, you will face three options to pay for a nursing home.

Medicaid** is a joint federal and state program that offers medical care to lower-income people. Since the income threshold to qualify for Medicaid is somewhat higher for nursing home residents, you should apply even if you think your income is too high. If you’re approved, Medicaid will pay for many nursing homes (but not all of them, so check to be sure that your preferred facility accepts Medicaid payments).

If you don’t qualify for Medicaid, hopefully you planned ahead with long-term care insurance. This is a type of insurance to research in your fifties or early sixties, ideally, because purchasing a policy earlier will mean lower premiums. In the event that you need a nursing home, this type of insurance picks up some or all of the bill.

And of course, you can simply pay for a nursing home out of your retirement income. But because these facilities can be expensive, it’s definitely better to budget for the expense before it ever occurs.

If you do need to stay in a nursing home, your Medicare plan will continue to pay for doctor visits, preventive services, hospitalizations, and medications as it usually does.

Speak to one of our licensed agents for more information on your Medicare coverage options if you’re not sure of the details. We can answer your questions and help you make well-informed decisions.

**Depending on the state where you reside, Medicaid may be known by a different name, such as MediCal in California or Soonercare in Oklahoma.  Click here to view a full list of alternative names for Medicaid by state.