MHI – Q: Does Medicare cover nursing home costs?

A: It’s a bit of a trick question. Medicare may pay for a short stay in a nursing home under very specific conditions but it will not pay at all if the only reason you are there is because you are no longer able to take care of yourself.

In order for Medicare to pay for a nursing home stay, you must have first spent a minimum of three days in the hospital as an inpatient and be in need of skilled services performed by a licensed medical professional. Episodes of skilled care that should be approved by Medicare are speech/language therapy following a stroke and physical therapy following a hip replacement.

Long term, or custodial care, is non-medical assistance that is not covered by Medicare. People in need of this type of care need help with activities of daily living such as bathing, eating or dressing.