Most nursing home care is considered custodial care (help with daily activities like bathing, dressing, and eating) rather than medical care. While nearly 97% of nursing home residents need help with bathing and over 90% need help with dressing and walking, Medicare has important limitations on what it will cover.
Medicare only pays for short-term skilled nursing facility care (up to 100 days) following a hospital stay of at least 3 days. For the first 20 days, Medicare covers all costs. From days 21-100, you pay $209.50 daily (2025 rate). After 100 days, Medicare stops paying completely.
The average nursing home costs about $9,277 monthly for a shared room ($111,324 yearly) or $10,646 for a private room ($127,752 yearly). With the average Social Security benefit at only $1,837.91 monthly in 2025, many seniors face a significant financial gap.
When Medicare stops paying, you have several options:
- Medicaid: Covers nursing home care for those with low income and limited assets, but you may need to spend down savings to qualify
- Long-term care insurance: Can help pay for care but is expensive and must be purchased before health problems develop
- At-home care: Medicare covers some medical home health services but not custodial care alone
- Non-profit care: Some facilities and foundations offer assistance
With 10,000 baby boomers turning 65 daily through 2030 and Alzheimer’s causing over 50% of nursing home admissions, understanding these coverage options is increasingly important for seniors and their families.
