Medicare does not cover long-term care. Here is what does

Your father is leaving the hospital and cannot go home alone. The discharge planner mentions a nursing facility, and you assume Medicare will handle it the way it handled the hospital stay.

It will, for a while. Then it stops, and the stopping point is where most families get hurt.

What does Medicare actually pay for?

Medicare covers skilled care: treatment from licensed medical professionals, such as rehabilitation or wound care after a hospital stay. Medicare.gov states plainly that Medicare does not pay for long-term care.¹ That means custodial care, the day-to-day help with bathing, dressing, eating and getting around that most people in a facility actually need.

The confusion comes from the skilled nursing benefit. After a qualifying hospital stay, Medicare covers up to 100 days in a skilled nursing facility per benefit period, according to Medicare.gov.² In 2026 you pay nothing for days 1 through 20, $217 a day for days 21 through 100, and the full cost from day 101 on.

Families watch Medicare pay the facility for a few weeks and conclude that Medicare covers nursing homes. It covers recovery. Once the need is mainly help with daily living rather than skilled treatment, Medicare coverage ends, and that can happen well before day 100.

How much does long-term care cost?

According to CareScout’s 2025 Cost of Care Survey, the 2025 national median cost of a semi-private nursing home room is $114,975 a year, and $129,575 for a private room.⁵ Assisted living runs about $6,200 a month in the same survey.⁵ The average retired-worker Social Security benefit in January 2026 was $2,074.53 a month, according to the Social Security Administration’s Monthly Statistical Snapshot for January 2026.⁶

For most families the math does not close. That is why the next program matters so much.

Who pays for long-term care after Medicare stops?

Medicaid. Medicaid is the largest payer of long-term care in the country, according to Medicaid.gov.³ It covers custodial care in a nursing home and, in many states, at home or in assisted living through waiver programs, though waivers usually do not cover room and board.

It is needs-based. In most states in 2026 a single applicant can hold about $2,000 in countable assets, according to the American Council on Aging’s state-by-state figures, though the limit varies widely.⁷ Illinois allows about $17,500, New York about $33,000, and California’s limit is $130,000 for an individual as of January 1, 2026.⁸ Many states let income above the limit go toward the cost of care rather than disqualifying the applicant.

Once approved, Medicaid pays the facility and your parent contributes most of their monthly income toward care, keeping a small monthly personal-needs allowance the state sets.

Medicare and Medicaid together. You do not have to choose. A person can have both at once, and is then called dual eligible. Medicare stays the main health coverage for doctors, hospital and prescriptions. Medicaid covers what Medicare leaves, most importantly long-term custodial care, and can also pay Medicare premiums and cost-sharing through the Medicare Savings Programs.

VA benefits. If your parent or their spouse served during wartime, Veterans Affairs programs may help pay for care. Ask before assuming they do not qualify.

State home-and-community programs. Many states fund help that keeps people out of facilities in the first place. Your local Area Agency on Aging knows what your state offers.

What should you do next?

1. Call your State Health Insurance Assistance Program (SHIP) or your state Medicaid office. Both give free, state-specific guidance, and SHIP counselors are trained on exactly this question.
2. Ask whether your parent is dual eligible, or close to it. The Medicare Savings Programs alone can be worth thousands of dollars a year.
3. Tour facilities before there is a crisis, and ask what the monthly cost is and who they expect to pay it. Decisions made under pressure are the expensive ones.
4. Do not give away assets to qualify without advice. For long-term care, Medicaid reviews the previous 60 months of finances (30 months in California), and gifts inside that window can trigger a penalty unless they fall under a state exception.⁸
5. Talk to an elder-law attorney or certified Medicaid planner before moving real money. One conversation can save a house.