Yes, nursing homes accept Medicare, but only for specific care and only for a limited time
Medicare covers skilled nursing facility (SNF) care — which is different from regular nursing home care. The distinction matters because Medicare will pay for a bed in a nursing home only if you need daily skilled nursing or rehabilitation services, such as wound care, physical therapy after surgery, or medication management that requires a nurse's oversight. If you need custodial care only — help with bathing, dressing, meals — Medicare does not pay, even if you are in a nursing home.
Medicare also limits how long it will pay. Coverage runs up to 100 days per benefit period, but only if you meet strict conditions: you must have been in a hospital for at least three consecutive days first, you must enter the nursing home within 30 days of hospital discharge, and a doctor must order the care. After 100 days, you pay the full cost yourself or turn to Medicaid if you meet its income and asset limits.
Most nursing homes do accept Medicare for the days it covers. The real question is not whether they accept it, but whether your specific stay qualifies for payment under Medicare's rules.
Key Takeaways
- Medicare covers skilled nursing care in a nursing home only after a hospital stay of at least three consecutive days, and only for up to 100 days per benefit period.
- You must enter the nursing home within 30 days of leaving the hospital, and a doctor must order the skilled care for Medicare to pay.
- Medicare does not cover custodial care — help with daily living tasks — even in a nursing home setting.
- After Medicare coverage ends, you pay out of pocket or through Medicaid, which is why understanding your coverage window matters before admission.
- The nursing home will verify your Medicare coverage and hospital stay before admitting you under Medicare; bring your hospital discharge papers.
What Medicare actually pays for in a nursing home
Medicare Part A covers skilled nursing facility care, which means nursing services and rehabilitation that require a trained nurse or therapist to deliver safely. Examples include intravenous antibiotics, wound dressing changes after surgery, physical therapy to regain mobility after a stroke, occupational therapy to relearn daily tasks, and speech therapy after a swallowing problem. The care must be ordered by a doctor and documented as medically necessary.
Custodial care — bathing, dressing, toileting, meal preparation, medication reminders — is not covered by Medicare, even if a nurse happens to be present. If that is the only care you need, Medicare will not pay. Many people enter a nursing home thinking Medicare will cover their stay and discover too late that their care does not may have access to.
The nursing home must be Medicare-certified, meaning it meets federal standards and has agreed to accept Medicare payment. Most large nursing homes are certified; some smaller facilities are not. When you or your family are considering a home, ask directly whether it is Medicare-certified and whether your specific care needs would may have access to for coverage.
The three conditions Medicare requires before it pays
Medicare will not pay for nursing home care unless all three of these conditions are met:
- Hospital stay of at least three consecutive days. You must have been admitted to a hospital (not an emergency room or observation unit) and stayed for three full calendar days. The day you are admitted counts as day one, even if you arrive at midnight. Observation stays do not count — Medicare distinguishes between inpatient admission and observation, and only inpatient counts.
- Admission to the nursing home within 30 days of hospital discharge. You must enter the nursing home no later than the 30th day after you leave the hospital. If you go home first and then enter a nursing home two months later, Medicare will not pay for that nursing home stay, even if you still need skilled care.
- A doctor's order for skilled care. The hospital doctor or your own doctor must order the skilled nursing or rehabilitation services. The order must be in writing and must state that the care is medically necessary. Without this order, the nursing home cannot bill Medicare.
If any one of these three conditions is not met, Medicare coverage does not explore. This is why it is critical to understand your hospital discharge paperwork and to move quickly if you need nursing home care.
How long Medicare pays and what happens after
Medicare covers up to 100 days of skilled nursing facility care per benefit period. A benefit period begins the day you enter the hospital and ends 60 days after you leave the nursing home (or 60 days after your last day of skilled care, whichever is earlier). If you need nursing home care again within that same benefit period, the days count against your 100-day total.
Your out-of-pocket costs change as your stay continues. For days 1 through 20, you pay nothing — Medicare covers the full cost. For days 21 through 100, you pay a daily coinsurance amount, which changes each year; in 2024, this is $194.50 per day, though you should confirm the current amount with your nursing home or Medicare. After day 100, you pay the entire cost yourself unless you are also covered by Medicaid or have a supplemental insurance policy.
Many people run out of Medicare coverage before they are ready to leave the nursing home. This is why it matters to understand the 100-day limit from the start. Some nursing homes will work with you to transition to Medicaid coverage if you meet the income and asset limits, but you need to plan for this before day 100 arrives.
How to verify Medicare coverage before or after admission
Before you enter a nursing home, ask the admissions staff to verify your Medicare coverage. Bring your Medicare card and your hospital discharge papers, which should include the dates of your hospital stay and the doctor's orders for skilled care. The nursing home's billing department will contact Medicare to confirm that your stay qualifies for payment.
You can also verify coverage yourself by calling Medicare at 1-800-MEDICARE (1-800-633-4227) and providing your hospital admission and discharge dates. Medicare will tell you whether your hospital stay meets the three-day requirement and whether you are within the 30-day window for nursing home admission.
After you are admitted, Medicare will send you a notice called the Notice of Medicare Non-Coverage if it determines that your care does not may have access to for payment. This notice must be given to you before Medicare stops paying, and you have the right to appeal. If you receive this notice, contact the nursing home's social worker or patient advocate when ready — they can help you understand your options and file an appeal if you disagree.
What to do if Medicare does not cover your nursing home stay
If Medicare does not pay because you did not meet the three conditions, or because your 100 days have run out, you have several options. The first is to pay out of pocket if you have the resources. The second is to explore Medicaid coverage, which has different rules and does cover custodial care, though it requires a lower income and very few assets. Each state runs its own Medicaid program, so may be able to access varies.
A third option is to move to a different level of care. If you no longer need skilled nursing but still need help with daily living, you might move to assisted living, which is less expensive than a nursing home. If you can manage at home with some support, home health services or adult day programs might work instead.
Talk to the nursing home's social worker or discharge planner before your Medicare coverage ends. They can help you understand what comes next and connect you with resources in your area. Do not wait until day 100 to start planning.
Frequently Asked Questions
Does Medicare cover the nursing home if I was in the hospital for observation, not admitted as an inpatient?
No. Medicare requires a hospital admission as an inpatient for at least three consecutive days. Observation stays, even if they last several days, do not count. Ask your hospital whether you were admitted as an inpatient or held for observation — this distinction is on your discharge papers and determines whether Medicare will pay for nursing home care afterward.
What if I need nursing home care but it has been more than 30 days since I left the hospital?
Medicare will not pay. You would need to pay out of pocket or explore Medicaid if you meet the income and asset limits. This is why timing matters — if you think you might need a nursing home, discuss it with your doctor before you leave the hospital so arrangements can be made within the 30-day window.
Can I use Medicare to pay for a nursing home if I only need help with bathing and meals?
No. That is custodial care, and Medicare does not cover it. Medicare only pays for skilled nursing or rehabilitation services that require a trained nurse or therapist. If you need only custodial care, you would pay out of pocket, explore Medicaid, or consider assisted living as a less expensive alternative.
What happens to my Medicare coverage if I leave the nursing home for a few days and come back?
If you leave for a brief stay (typically fewer than three days) and return, the days usually continue to count against your 100-day limit. If you are discharged and readmitted after more than three days, it may be treated as a new stay. Ask the nursing home to clarify how your specific situation will be counted before you leave.
Can a nursing home refuse to admit me if I only have Medicare coverage for a short time?
No. Federal law prohibits nursing homes from discriminating based on the source of payment or the length of coverage. However, the nursing home can require that you have a plan for payment after Medicare coverage ends — either out-of-pocket funds, Medicaid, or another source. Discuss this openly during the admission process.