How long does Medicare cover nursing home care?

Up to 100 days of skilled nursing facility care per benefit period, after a qualifying 3-day inpatient hospital stay. Days 1-20 fully covered; days 21-100 with a $217/day copay (2026); nothing after day 100. Critically, this is SKILLED nursing only — long-term custodial care isn't covered at all.

Will Medicare pay for assisted living?

No. Medicare does not pay for any portion of assisted living costs — no room and board, no personal care services, no medication management at an assisted living facility. Assisted living is paid by personal savings, long-term care insurance, Veterans benefits, or Ohio's Medicaid Assisted Living Waiver (for income-qualifying residents who need a nursing-home level of care).

If I exhaust the 100-day SNF benefit, what happens?

Three options: (1) pay privately, (2) qualify for Ohio Medicaid Long-Term Care (typically requires asset spend-down), or (3) discharge home or to a non-skilled facility. Many families work with elder law attorneys at this point to plan Medicaid eligibility while protecting a community spouse's resources. The transition from Medicare SNF coverage to Medicaid LTC is a high-stakes planning moment.

Can I keep my home and still qualify for Ohio Medicaid LTC?

Yes, in most cases — your primary residence is typically exempt from the Medicaid asset limit while you (or your spouse) live in it. However, after your death, Medicaid Estate Recovery may seek reimbursement from your estate, including the value of your home. Estate recovery rules are complex; elder law attorneys help families plan to minimize estate recovery.

What's the difference between skilled and custodial care?

Skilled care requires the expertise of licensed nursing or therapy professionals — IV medications, wound care, physical therapy, etc. Custodial care is assistance with activities of daily living (ADLs): bathing, dressing, eating, mobility, toileting, transferring. Medicare covers short-term skilled care; it doesn't cover custodial care. Long-term care insurance, Medicaid LTC, and personal savings cover custodial care.

Does Medicare cover hospice care?

Yes, comprehensively — Medicare Part A covers hospice care for beneficiaries with a terminal illness and a life expectancy of 6 months or less (as certified by a physician). Hospice covers medical care, prescriptions, equipment, counseling, and bereavement services. The hospice benefit is one of Medicare's most generous coverages. Hospice is provided in your home, a hospice facility, a nursing home, or a hospital, depending on your situation.

Does Medicare Cover Nursing Home Care in Ohio? (2026)

On this page

What Medicare actually covers for nursing care
The 100-day SNF limit explained
What Medicare doesn't cover (long-term care)
Ohio Medicaid Long-Term Care
PASSPORT and Ohio HCBS waivers
Long-term care insurance and other options
Common questions

What Medicare actually covers for nursing care

Medicare's skilled nursing facility (SNF) benefit covers short-term skilled care after a hospitalization. The rules:

Qualifying hospital stay: You must have been a hospital inpatient for at least 3 consecutive days (not counting the discharge day) before going to a SNF. "Observation status" hospital stays don't count — this is a major trap.
Skilled care requirement: The SNF must provide skilled nursing or rehabilitation care (physical therapy, occupational therapy, speech therapy, IV medication management, wound care, etc.) that you couldn't get at home or in a custodial setting.
Days 1-20: Medicare covers 100% of approved costs.
Days 21-100: You pay $217/day (2026 figure); Medicare pays the rest. Most Medigap plans cover this copay.
Day 101+: Medicare covers nothing. You're responsible for full cost (or Medicaid LTC, or LTC insurance, or family resources).

SNF coverage resets to a new 100-day benefit period after you've been out of inpatient hospital and SNF care for 60 consecutive days.

The 100-day SNF limit explained

The 100-day limit is per "benefit period," not per year. A benefit period starts the day you're admitted to a hospital or SNF and ends after 60 consecutive days without inpatient or SNF care.

Practical scenarios:

Hip replacement → SNF rehab: 3-day hospital stay, transferred to SNF for 30 days of rehab. Medicare covers everything except the days 21-30 copay ($217/day × 10 = $2,170 if you don't have Medigap). After SNF discharge, you start the 60-day clock for the benefit period to end.
Hospitalization → SNF → discharged → re-admitted within 60 days: You're in the same benefit period. SNF days count cumulatively — if you used 30 days the first time, you have 70 days remaining without starting fresh.
Hospitalization → SNF for 100 days → discharged → re-admitted 90 days later: 100-day SNF clock resets to a new benefit period.

Observation status is a major trap

Hospital 'observation status' (where you're physically in a hospital bed but technically an outpatient) does NOT count toward the 3-day inpatient requirement for SNF coverage. Many seniors discover after the fact that their hospital stay was observation, not admission — and their SNF stay is therefore not Medicare-covered. Ask hospital staff about your status every day; advocacy organizations like the Medicare Rights Center work on this issue. The CMS Hospital Improvement Act has changed some aspects of observation status; rules continue to evolve.

What Medicare doesn't cover (long-term care)

Medicare explicitly does NOT cover:

Long-term nursing home stays for custodial care (assistance with activities of daily living — bathing, dressing, eating, mobility) without skilled care need.
Assisted living facilities — Medicare covers no part of assisted living costs.
Memory care facilities — Medicare covers no part of memory care costs (Alzheimer's-specific residential care).
Adult day care or adult day services — not a Medicare benefit (some Medicare Advantage plans now offer day services as a supplemental benefit, but it's limited).
Personal care attendants at home — Medicare doesn't pay for someone to help with bathing, cooking, household tasks at home (unless you need skilled nursing care AND meet specific home health criteria, which is different).

For all of these long-term care needs, Medicare is not the answer. Ohioans rely on a combination of Medicaid LTC, family resources, long-term care insurance, and personal savings.

Ohio Medicaid Long-Term Care

Ohio Medicaid Long-Term Care is the primary payer for nursing home stays for Ohioans who can't afford to pay privately. To qualify, you must meet:

Medical need: A skilled level of care need, documented by physician and approved by Ohio's PASSPORT Administrative Agency or the Medicaid agency. Custodial-care need (ADL assistance without skilled need) doesn't qualify for nursing home Medicaid in Ohio.
Income limit: 2026 Medicaid LTC income limit in Ohio is approximately $2,901/month (300% of SSI federal benefit rate). Income above this is subject to "spend-down" or Miller Trust arrangements.
Asset limit: $2,000 in countable assets for an individual; spouse can keep additional resources under "spousal impoverishment" rules ($154,140 in 2026 community spouse resource allowance).
5-year lookback: Asset transfers in the 5 years before application can result in penalty periods of Medicaid ineligibility.

The application process is complex. Most families work with an elder law attorney to plan asset spend-down and protect a community spouse. Once approved, Medicaid covers nursing home costs indefinitely as long as eligibility continues.

PASSPORT and Ohio HCBS waivers

If you need long-term care but want to stay at home rather than enter a nursing home, Ohio operates several Medicaid Home and Community-Based Services (HCBS) waivers:

PASSPORT — the largest Ohio HCBS waiver, serving seniors 60+ who would otherwise need nursing home care. Provides in-home services (personal care, meals, transportation, adult day services, home modifications) to allow aging in place. Administered through Area Agencies on Aging.
Assisted Living Waiver — covers assisted living facility costs for Medicaid-eligible individuals who would otherwise need nursing home care.
MyCare Ohio — for dual-eligibles, the Next Generation MyCare Ohio plan integrates Medicare, Medicaid, and HCBS waiver services into one plan starting January 1, 2026.
Ohio Home Care Waiver — for younger adults (18-59) with disabilities who need long-term services.

Eligibility for HCBS waivers requires both medical need (level of care assessment) and financial qualification (similar to nursing home Medicaid rules, with some variations).

Ohio family planning long-term care for a parent or spouse?A licensed Ohio Medicare agent can connect you with elder law attorneys, Area Agencies on Aging, and Medicaid planning resources for your specific situation. No cost to you for Medicare guidance.

Find a Medicare Agent in Ohio

Long-term care insurance and other options

Long-term care planning beyond Medicaid includes:

Long-term care insurance — private insurance that pays for nursing home, assisted living, or in-home care. Premiums are most affordable when purchased in your 50s-early 60s; very expensive or unavailable later. Hybrid life-insurance-with-LTC-rider products have grown in popularity.
Personal savings — many Ohio families pay privately for nursing home or assisted living until savings are depleted, then transition to Medicaid LTC. Ohio nursing home costs average $7,500-$10,000/month; assisted living $4,000-$6,000/month.
Family caregiving — for many Ohioans, family members provide unpaid care at home for years before considering institutional care. Tax credits for dependent care, FMLA, and respite programs help.
Veterans Aid & Attendance benefit — VA-eligible veterans and surviving spouses can receive supplemental income to help pay for in-home, assisted living, or nursing home care.