Custodial care isn't covered
Medicare.gov says Medicare doesn't pay for long-term care, also called custodial care. That includes living in a nursing home because you need daily help, not daily skilled medical care.
Medigap doesn't cover it either. The usual routes are Medicaid, for people who meet their state's rules, or a private long-term care insurance policy.
Skilled nursing care is covered, for a time
Part A covers care in a skilled nursing facility, such as rehab after surgery, if you first had a medically necessary inpatient hospital stay of at least 3 days in a row and need daily skilled care. Time under observation or in the emergency room doesn't count toward the 3 days.
Coverage is limited to 100 days per benefit period. In 2026 you pay $0 for days 1–20 after the $1,736 Part A deductible, $217 a day for days 21–100, and all costs after day 100.
| Days in a skilled nursing facility | What you pay in 2026 |
|---|---|
| Days 1–20 | $0 a day (after the $1,736 Part A deductible) |
| Days 21–100 | $217 a day |
| Day 101 and on | All costs |
| Custodial (long-term) care | Not covered: all costs |
Planning for long-term care
Some Medicare Advantage plans can waive the 3-day hospital rule, though they may charge copays from day 1. Check the plan before you need it.
For custodial care, the decision is usually between Medicaid planning and long-term care insurance. See our long-term care service, or use the coverage gap calculator. One conversation is usually enough to know whether this matters for your situation.