Does Medicare Cover Nursing Homes? 

In the United States, Baby Boomers have entered their retirement years. According to the U.S. Census Bureau, the number of Americans over the age of 65 is expected to be somewhere around 82 million by the year 2050.

Additionally, advances in medical science and health research have meant that seniors are living longer lives. A report issued by the Pew Research Center estimates that the number of Americans living to be over 100 will quadruple in the coming decades.

While longer life expectancies are a good thing, seniors may consider planning for nursing home care during their later years. While some seniors are able to continue living independently well into their golden years, many find that nursing home care is required at some point due to chronic illness, injury or disability. This then leads to the question of whether Medicare covers nursing homes. With Medicare relied upon by more than 65 million seniors in America, understanding nursing home benefits may help you or a loved one.

How Medicare benefits may cover nursing homes?

Original Medicare does not cover nursing homes, but the program does cover some home health services. Medicare benefits cover inpatient care for a limited amount of time each year. Because Medicare coverage does not offer benefits for nursing home care, it’s a good idea for Medicare recipients to work with their doctors to discuss options for future medical care needs.

Medicare Part A and inpatient care

As mentioned, Medicare benefits are available for inpatient care in a hospital or skilled nursing facility (SNF) for a limited time each benefit period. Medicare Part A covers these expenses, and for most seniors, there is no monthly premium required to take advantage of Medicare Part A.

You will, however, need to meet an annual deductible before you can use Part A benefits. In 2024, the standard Part A deductible is $1,632. Once you have met this deductible, your inpatient benefits will cover up to 60 days of inpatient care in a Medicare-participating hospital or 20 days of inpatient care in a skilled nursing facility.

Beyond these limits, additional days are available, but a per-day coinsurance will be assessed for care. Hospital inpatient care can be extended for 30 days, and skilled nursing facility care can be extended for 80 days.

Medicare Part B and home health services

Medicare Part B is the outpatient portion of Medicare. It covers doctor visits, surgery and other types of outpatient services. The premium cost of Medicare Part B can vary based on your income, but aside from paying a monthly premium, you’ll have to meet an annual deductible to receive Part B benefits.

In conjunction with Medicare Part A, Medicare Part B may cover some home health services if you require nursing care; however, this coverage does not include nursing homes. The reason home health services may be split between Parts A and B is that some home health services covered by Medicare benefits are provided by nursing professionals employed by hospitals.

When a nurse from a hospital administers home health services, those services fall under Medicare Part A. You may also require prior hospitalization in order to receive home health services under Part A. Part B helps cover the costs of DME you may need while receiving care at home.

Do Medicare Advantage plans cover nursing homes?

Although Medicare Advantage plans offer additional benefits compared to Original Medicare, you will likely not receive nursing home coverage under a Medicare Advantage plan. Medicare Advantage plans provide at least the same coverage as Original Medicare Part A and Part B, so you can still receive coverage for inpatient care and home health services.

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