Medicare

Medicare pays for hospital treatment, limited home health services and even hospice, among many other things, but you’re out of luck if you were hoping to line up an extended stay in a nursing home. Most of the service provided in a nursing home is called custodial care—help with fixing meals, giving medicine, bathing, dressing, and going to the bathroom—and that’s exactly what Medicare doesn’t cover.

If you need help with day-to-day living and don’t have long-term care insurance, you or your family may have to pay for a nursing home. If your finances are grim, many state Medicaid programs will cover at least a significant portion of long-term care in a nursing home, which may be why so many people leap to the assumption that Medicare pays for such care.

Another cause for confusion might be Medicare’s one nursing home care exception—the skilled nursing facility benefit. This will pay for a short stay while you recover from a specific condition for which you were hospitalized at least three days. If you broke your hip, for example, and your doctor wants you to go to a nursing home to receive physical therapy or some other intensive medical care, Medicare will cover up to 100 days of your treatment. Actually, you’ll pay nothing for the first 20 days, and then $128 per day—the 2008 rate—from day 21 through day 100. After that, should you still need nursing home care, it will all be on your dime.