Where to start › Kind of care › Nursing care
Nursing-level care
A nursing home, also called a skilled nursing facility, gives care around the clock from nurses and aides to people who need medical watching. The confusing part is that two very different kinds of stay, paid for in very different ways, happen inside the same building.
Two very different things share one building
This is the most misunderstood point in elder care, so give it a few reads.
Short-term skilled care, the rehab stay. After a hospital stay, Medicare Part A may cover up to 100 days in each benefit period of skilled nursing or rehab that is medically needed, in a nursing home approved by Medicare. Two details decide if it applies at all:[1]
- Original Medicare normally requires the person to first be admitted to the hospital as an inpatient for at least three days in a row, for care that was medically needed.
- Time "under observation," or in the emergency room before being admitted, does not count toward those three days. People lose this benefit over that detail. While your person is still in the hospital, ask: have they been formally admitted as an inpatient, or are they under observation?
- Days 1–20: $0 a day, after the $1,736 Part A deductible. You do not pay that deductible again for the skilled nursing stay if you already paid it for hospital care in the same benefit period.
- Days 21–100: $217 a day.
- Day 101 onward: you pay all costs.
These are the Original Medicare amounts for 2026. A Medicare Advantage plan may charge differently, even during the first 20 days. The 100 days is the most Medicare will cover. It is not a number of days anyone is promised.
Long-term help with daily life. Living in a nursing home for ongoing help is a different thing. Medicare "doesn't cover custodial care if it's the only care you need." Custodial care means help with things like bathing, dressing or eating.[2] That is what most families mean by "the nursing home." Families pay for it themselves or, for many long-term residents in time, Medicaid pays. Part B still covers doctor visits and physical, speech or occupational therapy for a person living there.[2]
Our guide what Medicare actually pays for goes through the numbers for all of Medicare.
What to know before anyone tells you coverage is ending
Coverage can end before 100 days if the person no longer meets the conditions. But getting better is not one of the conditions. You may run into this. Medicare's own words say skilled nursing care or therapy must be needed "to improve or maintain your current condition, or to prevent or delay it from getting worse."[1]
So "she has plateaued" and "he isn't progressing" are not, by themselves, Medicare's reason for ending a skilled stay. If that is the reason you are given, ask for the decision in writing and ask how to appeal. This isa point we most wanted to make on this site, because the wrong version could cost families days that should have been covered.
Choosing a specific home
Nursing homes approved by Medicare have a public record: inspection results, staffing numbers and ratings. Medicare publishes it on its Care Compare website. We show it again in our directory, marked as coming from CMS and dated so you can see how fresh it is.[4]
Use it as one piece of the picture. Ratings and inspection results show one moment in time, and what gets measured changes over the years. A clean record is not a promise. A red flag is not a final verdict. Visit, and ask pointed questions. Questions to ask has them.
What only your state can tell you
Whether a person qualifies for Medicaid to pay for long-term nursing care is decided by the state, based on your own facts.
Who to ask: your state Medicaid office, and often an elder-law attorney for the money questions.
What to ask them:
- What are this state's income and savings limits for long-term-care Medicaid?
- Which nursing homes near us take Medicaid? Do they have Medicaid beds open now?
- How do we apply, and how long does it usually take?
- If my parent is married, how are the income and savings of the spouse at home protected? See protecting the spouse at home.
- Was my person admitted as an inpatient or kept under observation? How does that affect the skilled nursing benefit?
Free local help. Your Area Agency on Aging will talk through your choices with you for free. Find yours through the federal Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov (run by the Administration for Community Living).[5] Your state's SHIP counselors give free advice on Medicare choices and appeals. To learn about the four kinds of local helpers, see Who helps me locally.
Sources and what they support
Sources checked 2026-09-19 using AI-assisted editorial research. This is a source check, not benefits advice.
- Medicare, skilled nursing facility care. Supports the requirement of a prior medically necessary inpatient hospital stay of at least three days in a row, that observation and emergency-room time before admission do not count toward it, the 100-day limit in each benefit period, the quoted definition of skilled care as needed to improve or maintain the current condition or prevent or delay it getting worse, the 2026 cost-sharing of $0 a day for days 1–20 after the $1,736 deductible, $217 a day for days 21–100 and all costs from day 101, and that the deductible is not paid twice within one benefit period. There are specified exceptions to the three-day rule, a Medicare Advantage plan may apply different cost-sharing, and an individual claim is decided on that person's facts.
- Medicare, nursing home care. Supports that Part A may cover up to 100 days of short-term nursing home or rehabilitation care in a certified facility after hospitalisation, that Medicare generally does not cover long-term stays unless skilled nursing care is being received, the quoted rule that it does not cover custodial care if that is the only care needed, and that Part B covers doctor visits and physical, speech or occupational therapy for someone in a nursing home. "Not covered" here means not covered by Medicare; it says nothing about whether Medicaid or another payer might help.
- CMS, 2026 Medicare Parts A and B premiums and deductibles (14 November 2025). Supports the 2026 figures used here: the $1,736 inpatient hospital deductible and the $217 daily coinsurance for days 21 through 100 of extended care services in a benefit period. These are Original Medicare amounts for calendar year 2026 and are replaced each year, so check the year before relying on them.
- Medicare Care Compare. Supports that Medicare publishes comparative information on participating facilities, which is the source our directory republishes. The tool loads its content dynamically and we could not extract its current field list in this pass, so this page does not claim a specific set of published fields. Ratings and inspection data are snapshots, definitions change, and neither a clean record nor a flag settles what a facility is like today.
- Administration for Community Living, Eldercare Locator. Supports the referral route to a local Area Agency on Aging. It does not determine Medicaid eligibility or handle Medicare appeals.
Corrected in this pass: the page said Medicare gives "full coverage only for the first 20 days" without the deductible condition or the 2026 amounts; it did not mention the three-day inpatient rule or that observation time does not count, which is how families most often lose this benefit; and it did not carry Medicare's maintenance standard, which is the claim most often got wrong against families.