2025 Guide
Medicare and Senior Care: What's Actually Covered
The most common financial shock in senior care: families assume Medicare will pay for it. Here's the honest breakdown.
Medicare covers
- Short-term skilled nursing (days 1–20 free, 21–100 with copay)
- Hospice care (100% covered for terminal diagnosis)
- Skilled home health care (nursing, PT, OT — when homebound)
- Hospital stays (Part A)
- Doctor visits and outpatient care (Part B)
Medicare does NOT cover
- Assisted living
- Memory care
- Long-term nursing home stays (after 100 days)
- Non-skilled home care (bathing, meals, housekeeping)
- Adult day services (in most states)
The 4 Parts of Medicare
Medicare Part A
Hospital & Skilled Nursing
- Hospital inpatient stays
- Skilled nursing facility: 100% days 1–20 after qualifying hospital stay
- Days 21–100: $204/day copay (2025)
- After 100 days: no coverage
- Hospice care: fully covered
Medicare Part B
Medical & Outpatient
- Doctor visits and specialist care
- Outpatient therapy (PT, OT, speech)
- Preventive care and screenings
- Durable medical equipment
- Does NOT cover long-term custodial care
Medicare Part C
Medicare Advantage
- Bundles Part A + B through private insurers
- Some plans include dental, vision, hearing
- Some plans add extra home care benefits
- Drug coverage often included
- Compare plans yearly — benefits change
Medicare Part D
Prescription Drugs
- Covers outpatient prescription medications
- Purchased separately or through Part C
- Compare formularies annually
- Avoid late enrollment penalties
Medicare Advantage Plans
Compare plans in your area
Medicare Advantage (Part C) plans vary widely by insurer and location. Some plans include dental, vision, hearing, and limited home care benefits that Original Medicare doesn't cover. The official Medicare plan finder lets you compare every plan available in your zip code — it's free, takes about 5 minutes, and is run by the federal government.
Compare plans on Medicare.govCommon questions
Does Medicare cover assisted living?
No. Medicare does not cover assisted living. Assisted living is considered custodial care, not skilled medical care. Most families pay for assisted living through private funds, long-term care insurance, or Medicaid waivers.
Does Medicare cover home care?
Medicare covers skilled home health care only — nursing visits, physical therapy, occupational therapy — when ordered by a doctor and when the person is considered homebound. It does NOT cover non-skilled home care like help with bathing, meals, or housekeeping.
Does Medicare cover nursing homes?
Medicare covers short-term skilled nursing facility stays after a qualifying hospital inpatient stay of 3+ days. It covers 100% of costs for days 1–20, then a daily copay for days 21–100. After 100 days, Medicare coverage ends. Long-term nursing home stays are not covered by Medicare.
Does Medicare cover hospice?
Yes. Medicare Part A covers hospice care 100% for individuals with a terminal prognosis of 6 months or less who choose comfort-focused care. There are no deductibles for hospice services.