In this guide 3 sections
Assisted living and nursing home care can create a major financial problem. In 2025, the national median was $6,200 a month for assisted living and $9,581 a month for a shared nursing home room. Local prices can differ substantially.
Start with Medicaid
- 1.Contact the state Medicaid agency and request a long term care eligibility screening.
- 2.Ask what financial documents and functional assessment the state requires. Medicaid long term care eligibility includes financial rules and a state test of the person’s need for care.
- 3.For nursing home care, confirm that the facility is licensed and Medicaid certified. Medicaid nursing facility coverage applies only in a Medicaid certified facility.
- 4.For assisted living, ask the state Medicaid agency whether it covers any services in that setting. State rules differ.
- 5.Compare the facility’s private price, any existing long term care insurance, and possible Medicaid help. If care follows a hospital stay, also ask whether Medicare will cover short term skilled nursing care.
What each program may pay
- Medicaid: It can cover nursing facility services for an eligible person who meets the state’s financial and level of care rules.
- Medicare: It does not pay for most long term custodial care in assisted living, a nursing home, or the community.
- Private funds or insurance: A person may pay from income or savings, or use an existing long term care insurance policy.
When Medicare may cover a nursing home stay
Medicare Part A may cover skilled nursing facility care for a limited time when its requirements are met. These generally include a qualifying inpatient hospital stay, entry into the facility within about 30 days, a need for daily skilled care, and use of a Medicare certified facility.
In 2026, Part A limits skilled nursing facility coverage to 100 days in each benefit period. The person pays all costs after day 100. This benefit is not ongoing payment for custodial nursing home care.
Questions families ask
Does someone have to use all savings before Medicaid helps?
Medicaid has financial eligibility rules, but the limits, exclusions, and treatment of income and assets vary by state. Federal rules also include protections involving spouses. Ask the state Medicaid agency to review the person’s exact finances before spending or transferring assets.
Can someone stay in the same nursing home after private funds run low?
Sometimes. Many nursing homes accept both private payment and Medicaid, but Medicaid payment requires a Medicaid certified nursing facility. Ask the facility whether it is Medicaid certified and whether the person could remain there after becoming eligible.
Does Medicaid pay for assisted living?
There is no single nationwide answer in these sources. Ask the state Medicaid agency whether it covers any services in assisted living, what eligibility rules apply, and which local facilities participate. Medicare does not pay for most long term custodial care in assisted living.
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