Frequently Asked Questions Regarding Medicare

Q: Does Medicare pay for nursing home stays?
A: Medicare will only pay for a stay in a nursing home or long term in-house nursing care if ordered by a doctor because the individual needs skilled nursing home services. In cases where an individual needs care because they are having a hard time taking care of themselves, Medicare will not pay for these types of nursing home stays. Specifically, Medicare will not pay for an individual who needs daily living custodial care in a nursing home. Activities which are considered daily living assistance involve walking, eating, dressing, grooming oneself, bathing, and other basic services.

In cases where an individual needs custodial care for personal daily living assistance, if Medicare does not pay for these expenses, under certain circumstances Medicaid will pay for these expenses.