Medicare does not cover custodial care, including residency at a nursing home, but it typically covers skilled nursing facility care, hospice care, and some medically necessary in-home care services.

Custodial care is non-medical care that people receive when they need help with daily living, such as dressing or eating. In older age, this assistance can come from having a caretaker at home or living in a nursing home.

That said, custodial care is different from skilled nursing care, which is assistance with medical tasks such as changing dressing. Generally speaking, Medicare only covers long-term skilled nursing care, not custodial care.

That said, keep reading to learn what type of long-term care is covered under Medicare, who is eligible for coverage, and how to get help paying for it.

Medicare Part A covers certain types of medically necessary long-term care.

Skilled nursing facilities

A skilled nursing facility (SNF) can provide medical or health-related services from a professional or technical staff to monitor, manage, or treat a health condition after a qualifying inpatient stay in a hospital. Staff at an SNF include professionals such as:

Examples of when someone might need SNF care include:

  • recovering from an acute health condition, such as a heart attack or stroke
  • physical or occupational therapy after an injury or surgery
  • care that requires intravenous (IV) medications, such as after a severe infection or long illness

Hospice care

Hospice care is a special type of care that someone receives when treatment to cure a serious illness has stopped and a doctor certifies that the person seeking hospice care has a life expectancy of six months or fewer. Hospice care focuses on managing symptoms and providing support.

Examples of services provided during hospice care include:

  • care from doctors and nurses, including exams and visits
  • medications or short-term inpatient care to manage symptoms and ease pain
  • medical devices or supplies, such as wheelchairs, walkers, or bandages
  • physical and occupational therapy
  • short-term respite care, which involves care at a nursing home or hospital during times when a caregiver is not available
  • grief counseling for your family and loved ones

In-home care

Part A covers in-home care while you need after being released from a hospital or an SNF. If you need it at home without prior hospitalization, it will be covered by Part B.

In-home care involves any healthcare services you receive at home instead of a hospital or doctor’s office. Typically, these in-home care services are coordinated with a home healthcare agency. Both Medicare Parts A and B can cover this type of care.

Services provided during in-home care can include:

  • part-time skilled nursing care or hands-on care
  • physical therapy
  • occupational therapy
  • speech-language therapy
  • wound care

Medicare covers medically necessary services only. Therefore, custodial care, meal preparation, and cleaning aren’t covered.

Once enrolled in Original Medicare, you can receive coverage for long-term care. Generally, to receive Medicare benefits, you must first be eligible for Original Medicare (Part A and Part B) by meeting one of the following requirements:

  • Be 65 years or older: You can enroll beginning 3 months before your 65th birthday.
  • Have a disability: You can enroll beginning 3 months before you reach the 25th month of receiving disability benefits.
  • Have end stage renal disease or amyotrophic lateral sclerosis (ALS): Enrollment times can depend on your individual situation.

Eligibility for an SNF

To qualify for coverage to stay at an SNF, you must first have a qualifying hospital stay. This stay must last at least 3 consecutive days and be classified as “inpatient.”

Your doctor must also document that you need daily inpatient care or supervision that can be given at an SNF only. You’ll typically need to enter the SNF within 30 days of leaving the hospital.

Eligibility for hospice

To be eligible for hospice care coverage, you must:

  • Have an estimated life span of less than six months, although your doctor can extend this if necessary.
  • Choose to accept palliative care instead of treatment to cure your condition. Palliative care is focused on providing comfort and support.
  • Sign a statement indicating that you’ve chosen hospice care for your condition instead of other Medicare-covered treatments.

Eligibility for in-home care

If you have Original Medicare, you qualify for in-home care if your doctor classifies you as “homebound.” This means that you have trouble leaving home without assistive equipment (such as a wheelchair) or the help of another person.

Your doctor must also certify that you need skilled medical services that can be provided at home. Examples include part-time skilled nursing care, physical therapy, or occupational therapy. Your doctor will create a plan of care for you.

Medicare Part A covers short stays at an SNF. Most people don’t pay a premium for Part A, but you must meet a $1,676 deductible in 2025. Afterward, your cost depends on the length of your stay as follows:

  • Days 1 through 20: Part A pays for any covered services.
  • Days 21 through 100: Part A pays for all covered services, but you’re now responsible for a daily coinsurance payment. For 2024, this is $209.50 per day.
  • After 100 days: Part A pays nothing. You’re responsible for the entire cost of SNF services.

When it comes to hospice care or in-home care covered by Part A, Medicare generally covers all costs, with the possible exception of small copays for respite care or prescriptions.

But, Medicare doesn’t pay for room and board while you’re receiving hospice care. It also no longer covers some expenses after hospice benefits start, such as medication or treatment intended to cure an end stage illness. It’s important to coordinate a plan with a hospice care team to ensure everything is organized and covered.

With in-home healthcare covered by Part B, you won’t pay anything for covered in-home healthcare services. You will, however, need to pay 20% of the cost for necessary durable medical equipment (DME) after you meet the Medicare Part B deductible of $257.

Examples of DME include:

  • wheelchairs
  • walkers
  • hospital beds

In addition, you have to pay a premium for Part B, which starts at $185.

Medigap

You can consider enrolling in a Medicare Supplement (Medigap) plan, which may help cover some of your remaining out-of-pocket costs not covered by Original Medicare.

Medicare Advantage

If you’re insured by Medicare Part C (Medicare Advantage) instead of Original Medicare (parts A and B), you get equivalent coverage for long-term skilled care.

But, as Part C plans are managed by private insurers, some plans may offer additional coverage, including custodial care. Contact your insurer directly or examine your benefits package to determine exact coverage.

That said, you cannot use Medigap with Medicare Advantage. In addition, these plans have varying premiums, deductibles, and coinsurance amounts depending on your plan and location. According to the Centers for Medicaid & Medicare (CMS), the average monthly premium for Part C plans is around $17.00 in 2025.

For additional help with long-term care or custodial care that isn’t covered by Medicare, consider the following options:

  • Medicaid: Medicaid is a joint federal and state program that supplies healthcare for free or at a low cost. The available programs and income eligibility requirements can vary by state. Find out more through the Medicaid site.
  • Long-term care insurance: Some insurance companies sell long-term care insurance policies, which are meant to cover long-term care, including custodial care.
  • Program of All-inclusive Care for the Elderly (PACE): PACE is a program that’s available in some states to help cover costs associated with medical or long-term care provided at home. Visit the PACE site to learn more.
  • Department of Veterans Affairs (VA): The VA may help provide long-term care for some veterans. To learn more about potential benefits, contact your local VA health center or visit the VA site.
  • Out of pocket: If you choose to pay out of pocket, you’ll be paying for all the long-term care costs on your own.

Medicare covers some types of long-term care, including in-home care, hospice care, and short stays at SNFs. To be eligible for coverage, you must meet certain requirements.

Some aspects of long-term care aren’t covered by Medicare. These include nonmedical services commonly provided at nursing homes and assisted living facilities, such as custodial care and room and board.

You may have additional ways to get assistance for the costs of long-term care. These include enrolling in an Advantage or Medigap plan, enrolling in Medicaid, or buying a long-term care insurance policy.