Call SelectQuote
Work with one of our licensed insurance agents to get answers to your Medicare questions, unbiased comparisons of coverage and resources to simplify the entire process. Call 1-833-574-3011 (TTY: 1-877-486-2048) to get started.
Are all of your needs covered with Original Medicare? Let’s find out.
SelectQuote’s licensed insurance agents can help you understand Medicare Advantage coverage options, make sure you choose a plan that fits today, and continue to support you year-round. It’s free, and there’s no obligation to enroll.
Original Medicare Long-Term Care Coverage and Hospice Needs
Does Medicare cover long-term care? Generally, the answer is no. Original Medicare does not pay for custodial care, which is help with daily activities like bathing, dressing, or using the bathroom. Most people who need long-term care require non-medical help.
While Medicare Part A and Medicare Part B are vital for hospital stays and doctor visits, they are not designed for long-term stays in a nursing home or assisted living facility.
Does Original Medicare cover long-term care needs?
To understand your coverage, it helps to know the difference between skilled care and custodial care. Medicare is designed to pay for medical recovery, not daily supervision.
Type of Care | What is it? | Is it covered? |
Skilled Care | Medical care from nurses or therapists (like physical therapy). | Yes (Short-term) |
Custodial Care | Help with activities of daily living (bathing, eating, dressing). | No |
If you need help with daily tasks, those are usually out-of-pocket expenses. Knowing the difference between a skilled nursing facility and a nursing home can help you plan for these costs.
Medicare Nursing Home Care
It is important to know that Original Medicare only pays for medical services provided within a facility—it does not pay for your room and board (the cost of living there).
Original Medicare doesn’t pay for most nursing home care unless you need skilled nursing care for a short time. Medicare Advantage plans (also called Medicare Part C) may offer some extra benefits. Always check with your plan before making arrangements to enter a facility.
Original Medicare and Skilled Nursing Facilities (SNF)
If you need rehab after a hospital stay, you may go to a skilled nursing facility. To qualify, you must have a qualifying hospital stay, which means being a hospital inpatient for at least three days in a row before moving to the SNF.
Medicare Part A helps cover the costs of your stay for a limited time:
Days 1–20: $0 copayment per benefit period
Days 21–100: You pay a daily coinsurance ($217 per day in 2026)
Days 101 and beyond: You are responsible for all costs
How do Original Medicare and Medicaid work together for long-term care?
If you run out of Medicare coverage or don’t meet the medical requirements for an SNF, Medicaid might help. Medicaid is a joint federal-state program. It is one of the few ways to get help with long-term custodial care costs. You can learn more about the difference between Medicare and Medicaid here.
Understanding Medicaid Spend Down Rules 2026
To qualify for Medicaid, you must have a low income and limited assets. Many people use a "spend down" process. This means you spend your own savings on medical care and long-term care costs until your assets reach your state’s limit. Once you meet the financial threshold, Medicaid can begin to pay for your care.
Medicaid Waiver Programs for Memory Care
Does Original Medicare pay for long-term memory care? Usually, it does not. However, many states offer home and community-based Services (HCBS) waivers. These programs can help pay for care for those with dementia or Alzheimer’s, allowing them to receive support at home or in the community instead of a nursing home.
Planning for Costs Not Covered by Medicare
Since Original Medicare has gaps, many families must plan ahead for the high costs of assisted living and memory care.
Average Cost of Assisted Living by State
Does Original Medicare pay for assisted living? No. The cost for these facilities is usually paid privately. These prices vary depending on where you live. For example, care on the East Coast or West Coast is often much more expensive than in the Midwest or South. Geographic location is one of the biggest factors in long-term care planning.
Long-Term Care Insurance for Alzheimer’s and Chronic Illness
Because Original Medicare doesn't cover long-term dementia care, many people look into private long-term care (LTC) insurance. This insurance is designed to bridge the gap. It can help pay for memory care, home health aides, and assisted living—services that help those with chronic illnesses live safely.
Will a Part D Prescription plan help?
Yes. If you live in a long-term care facility, your Medicare Prescription Drug plan (Part D) still covers your medications. The facility will usually fill your prescriptions through its own pharmacy. You are allowed to switch drug plans while living in a facility, and you can also switch if you move out.
Original Medicare and Hospice Care
Hospice is for end-of-life care, not standard long-term care. If you have a terminal illness, Medicare hospice benefits cover almost everything related to your comfort and pain management.
Medicare Part A covers:
Doctor and nursing care
Medical equipment (like walkers) and supplies
Drugs for pain relief (with a small copayment)
Grief counseling for you and your family
Respite care (to give your regular caregiver a break)
If you have a Medicare Supplement (Medigap) plan, it may help cover the small remaining costs for hospice.
What’s NOT covered by your Medicare Part A hospice benefits?
While your Original Medicare hospice benefit covers many types of care, it will not cover certain things, such as:
A treatment or prescription medication intended to cure your terminal illness.
Any care not set up by an approved hospice care team.
Your room and board should you receive hospice care where you live.
Any ER care, inpatient care, or ambulance transport not related to your terminal illness or not arranged by your hospice care team.
Let SelectQuote Help
Understanding Original Medicare's limits can be stressful, but you don't have to do it alone. Our licensed agents can help you compare plans and find the right coverage for your needs. We will also stay with you year-round to ensure your coverage remains the right option. Our service is free, and there is never an obligation to enroll.
We do the shopping. You do the saving.
No obligation to enroll
SelectQuote Senior Insurance Services is a division of SelectQuote Insurance Services. © 2026 SelectQuote Senior Insurance Services. All rights reserved.
Please see the Disclosures Page for more information.
MULTI-PLAN_SQSRW2026_M
Looking for an affordable Medicare plan? Let us help.
We’ll call you.
If you’re pressed for time, complete this form and a member of our team will call you at your selected time.