Long-term care costs: what doesn’t Medicare pay?

More than half of people turning 65 today will need some kind of long-term care during their lives.

What does long-term care cost?

Here are national median costs for 2025, according to CareScout's annual survey:

Costs vary widely by state and city.

What does Medicare cover?

Medicare pays for skilled care, meaning medical care from licensed professionals, for a limited time. It doesn't pay for custodial care, which is help with daily living.

• Skilled nursing facility care: After a hospital stay of at least three days as an admitted patient, Medicare can cover up to 100 days in a skilled nursing facility per benefit period, if you need daily skilled care. Currently, Medicare pays in full for the first 20 days. For days 21 to 100, you pay up to $217 a day. After day 100, you pay everything.
• Home health care: Medicare covers part-time skilled care at home, like nursing or physical therapy, if you're homebound and a doctor orders it. However, it doesn't cover full-time care or help with only personal care.
• Hospice: Medicare covers hospice care for people with a terminal illness.

Medicaid

Medicaid pays for more long-term care than any other program. It can cover nursing home care and, in a lot of states, care at home or assisted living through waiver programs. However, be prepared to be on a waitlist.

To qualify, your income and savings have to be pretty low. In a lot of states, that means having no more than about $2,000 in assets as a single person. Your home, one car, and personal belongings usually don't count.

• Protections for spouses: If one spouse needs nursing home care, the other spouse can keep the home and a share of the couple's savings and income.
• The five-year look-back: Medicaid goes over money and property you gave away or sold below value in the five years before you apply.
• Estate recovery: After a Medicaid recipient dies, states can try to get repayment from their estate, sometimes including the home.

Other ways to pay

• Long-term care insurance: These policies pay for care at home or in a facility and are most affordable when you buy them in your 50s or early 60s, while you're healthy. Premiums can rise over time.
• Hybrid life insurance: Some life insurance policies let you use part of the death benefit for long-term care.
• Veterans benefits: Veterans and surviving spouses may qualify for VA pensions with Aid and Attendance, which help pay for care.
• PACE programs: The Program of All-Inclusive Care for the Elderly helps people 55 and older get care at home and in the community.
• Family caregiving: Most long-term care in the U.S. is provided for free by family members. Some states let Medicaid pay family caregivers.

How to plan ahead

• Talk with your family about what you want and who could help.
• Make a durable power of attorney and a health care proxy.
• Look into local services through your Area Agency on Aging.
• Consider insurance if you're still healthy enough to qualify.