Medicare & Skilled-Need Coverage

What it is

Medicare is federal health insurance for people 65 and older (and some younger people with disabilities). It is the baseline coverage nearly every American senior already has — and the most persistent point of confusion in long-term care planning, because most people assume Medicare will fund a nursing home stay. It will not, beyond a narrow, short-term exception.

What Medicare actually covers

• Skilled nursing facility care: up to 100 days per benefit period, and only after a qualifying inpatient hospital stay of at least 3 days. Days 1–20 are covered in full; days 21–100 require a daily coinsurance amount; after day 100, Medicare pays nothing — see Medicare.gov's official skilled nursing facility coverage page for the current rules.
• Home health care: intermittent skilled nursing or therapy, generally for a limited window tied to a specific medical need — not ongoing custodial help with bathing or dressing.
• Hospice care: comprehensive comfort-focused care for a terminal diagnosis with a life expectancy of six months or less.

Who it fits

Everyone 65 and older should understand Medicare's actual scope before assuming it will fund an extended stay. Medicare is the starting point for every planning conversation, not the end point.

Medigap and Medicare Advantage

Supplemental Medigap policies and Medicare Advantage plans can reduce out-of-pocket costs for the skilled-care benefits Medicare does cover, and some Medicare Advantage plans now offer limited supplemental benefits (like adult day care or in-home support). Neither category converts Medicare into a custodial long-term care benefit — the 100-day skilled nursing limit and the rehabilitative-only home health rule still apply. The official Medicare.gov long-term care coverage page and the Administration for Community Living's overview of who pays for long-term care both walk through this gap in more detail.