Is nursing home & long-term care covered by insurance?
Long-term custodial care in a facility or at home. Here’s how each kind of plan usually handles it.
- Employer or MarketplaceUsually not covered
No, health insurance doesn’t cover long-term custodial care.
More details
Ongoing help with daily activities is usually paid for by long-term care insurance, your own savings, or Medicaid.
Cost: Usually paid out of pocket or by long-term care insurance.
- Original MedicareUsually not covered
No, Medicare doesn’t cover long-term custodial care.
More details
Medicare covers only short-term skilled nursing after a hospital stay.
- Medicare AdvantageUsually not covered
No, Medicare doesn’t cover long-term custodial care.
More details
Medicare covers only short-term skilled nursing after a hospital stay. plans don’t have to cover it, but some include it as an extra benefit: check your plan’s .
- MedicaidCovered with conditions
Yes, Medicaid is the main payer for nursing home care, if you qualify.
More details
Eligibility depends on income, assets, and level of care. Many states also fund home- and community-based care as an alternative.
What usually has to be true
- To qualify for Medicaid, your income and savings must be under the limits, and the state looks back at money you gave away.
Good to know
- Assisted living is rarely covered by any health insurance; some state Medicaid waivers help.
- Medicare pays for short respite stays only for people in hospice. Medicaid waiver programs and local Area Agencies on Aging often help with respite and adult day care.
Related
- Skilled nursing facility · Short-term rehab in a skilled nursing facility after a hospital stay.
- Home health care · Skilled nursing and therapy visits at home.
Sources
Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.
- 1What Marketplace plans cover
HealthCare.gov
Marketplace plans cover outpatient care, hospitalization, mental health care, prescription drugs, rehabilitation, laboratory services, preventive services, and other essential benefit categories.
- 2Long-term care
Medicare.gov
Medicare does not cover long-term custodial care: help with bathing, dressing, eating: when that is the only care you need.
- 3Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
- 4Mandatory and optional Medicaid benefits
Medicaid.gov
States must cover mandatory benefits such as inpatient and outpatient hospital care, physician services, laboratory and X-ray services, home health, and nursing facility care; many other benefits, including adult dental, vision, and prescription drugs coverage details, are state options.
General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.