Medicare & Medicaid
Medicare won't pay
for most long-term care.
It's the most common and most expensive misunderstanding in retirement planning. Here's what the government programs actually cover.
| Medicare | Medicaid | |
|---|---|---|
| Who qualifies | Age 65+ or certain disabilities | Low income and low assets (state rules) |
| Skilled nursing facility | Up to 100 days after a 3-day inpatient stay; 2026: $0 days 1–20, $217/day days 21–100 | Yes, once eligible |
| Custodial care (help with daily activities) | No | Yes, once eligible |
| Assisted living | No | Limited, varies by state |
| In-home care | Part-time skilled care only | Varies by state and waiver programs |
| What it costs you | Premiums and coinsurance | Spending down most of your assets first |
Source: CMS 2026 Medicare cost-sharing. Medicaid eligibility and coverage vary by state. General information only.
Why it matters
The gap is where savings disappear
Medicare covers the short stay. Medicaid covers you once your savings are mostly gone. Everything in between is paid by you or your family, unless you have a plan.
Asset-based long-term care is designed to fill that gap, so you keep your savings, your choices and your family's inheritance.
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Medicare & Medicaid questions
Does Medicare pay for assisted living?
No. Medicare doesn't pay for room and board or personal care in assisted living.
Does Medicare pay for in-home care?
Medicare can cover part-time skilled home health care if you're homebound and need skilled services. It does not cover full-time or custodial in-home care.
What is the Medicaid look-back period?
When you apply for Medicaid long-term care, most states review asset transfers made in the prior 60 months. Gifts or transfers for less than fair value can create a penalty period. Rules vary by state, so talk to an elder law attorney.
Your next step
See your numbers before you decide anything.
A free, no-pressure review. We'll compare asset-based long-term care options from top-rated carriers side by side, including what happens if you never need care.