Key Takeaways
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Medicare is starting to offer broader support for long-term care needs in 2025, particularly after hospital stays, but there are still strict limits on duration and type of services.
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If you or a loved one anticipate needing extended care beyond short-term recovery, you’ll likely need to explore other financial resources or programs beyond Medicare.
Understanding What Medicare Covers in Long-Term Care
Long-term care is not just about nursing homes. It includes a broad range of services such as help with daily living activities—bathing, dressing, eating, and mobility—as well as more intensive medical support. However, Medicare’s role in this area remains narrow, even in 2025.
Medicare generally does not cover custodial care if that’s the only care you need. Custodial care refers to non-medical assistance with activities of daily living. But Medicare does cover certain skilled services and rehabilitation—if they are medically necessary and follow a qualifying hospital stay.
Skilled Nursing Facility (SNF) Coverage Rules
Medicare Part A covers care in a skilled nursing facility, but only under specific conditions:
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You must have had a qualifying inpatient hospital stay of at least three consecutive days, not including the discharge day.
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You must enter a Medicare-certified SNF within 30 days of leaving the hospital.
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The care must be for the same condition treated during the hospital stay or a related condition.
What You Get in 2025
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Days 1–20: Covered in full for each benefit period.
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Days 21–100: You pay a daily coinsurance amount.
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After day 100: You are responsible for all costs.
This coverage resets with a new benefit period, which begins after you’ve gone 60 days without receiving skilled care.
In-Home Health Services Under Medicare
In some situations, Medicare can provide coverage for long-term care needs in the home through its home health benefit. However, the conditions are strict:
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You must be homebound, meaning it’s extremely difficult to leave home without assistance.
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A doctor must certify that you need intermittent skilled nursing care, physical therapy, or speech-language pathology.
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A Medicare-certified home health agency must deliver the care.
Medicare covers 100% of these services when approved, including part-time skilled nursing and therapy, along with limited home health aide assistance.
But keep in mind, custodial services alone are never covered, even if they’re delivered by a home health aide.
What Medicare Advantage Plans May Offer
As of 2025, Medicare Advantage (Part C) plans are permitted to offer supplemental long-term services and supports (LTSS) that traditional Medicare doesn’t cover. These might include:
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Adult day care services
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Respite care
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Transportation for non-medical needs
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Home safety modifications
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In-home caregiver support
That said, these benefits are optional and vary widely by plan and region. You’ll need to review plan materials or speak with a licensed agent listed on this website to confirm what’s available in your area.
Coverage for Hospice and End-of-Life Care
When long-term care needs become part of end-of-life planning, Medicare coverage becomes more comprehensive. Under Medicare Part A, hospice care includes:
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Pain relief and symptom management
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Home nursing support
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Counseling services
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Respite care for caregivers
To qualify, a doctor must certify that you are terminally ill with a life expectancy of six months or less, and you must choose to receive comfort care instead of curative treatments.
Hospice care is usually provided in the home but can also be delivered in hospice centers or nursing facilities when necessary.
The Gaps That Still Exist in 2025
Even though Medicare is expanding access to certain types of care, there are still major limitations that you need to understand:
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No custodial care: Ongoing help with dressing, bathing, or toileting isn’t covered unless part of a skilled care plan.
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No long-term nursing home stays: After 100 days in a SNF, you’ll need to pay fully out-of-pocket or use other coverage.
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No assisted living coverage: Medicare does not cover room and board in assisted living facilities, even if care is provided onsite.
This means that if you need help for months or years, whether in a facility or at home, Medicare alone won’t be enough.
Financial Options Outside of Medicare
Since Medicare doesn’t provide full long-term care coverage, it’s important to consider other options for paying these expenses:
Medicaid
Medicaid is the largest public payer of long-term care in the U.S. It may cover nursing home costs and some home- and community-based services if you meet income and asset requirements. Eligibility varies by state.
Long-Term Care Insurance
This private insurance product helps cover services that Medicare doesn’t. Policies vary, but many include nursing home care, home care, and assisted living. However, premiums can be high and increase with age, and you generally must buy this coverage before you need care.
Hybrid Life Insurance
Some life insurance policies come with long-term care riders, allowing you to use part of the death benefit to pay for care. This can offer flexibility, though terms differ across policies.
Veterans Benefits
If you’re a military veteran, you may qualify for long-term care services through the Department of Veterans Affairs. Benefits depend on your service history, income, and level of need.
How Medicare’s Role Has Evolved
Over the years, Medicare has adjusted to reflect new care needs and aging demographics:
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In 2020 and 2021, Medicare began experimenting with flexible benefits under Medicare Advantage to address social determinants of health.
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By 2023, CMS expanded the definition of supplemental benefits, allowing more plans to include non-medical services tied to health conditions.
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In 2025, many of those changes are now being implemented more broadly, though standard Medicare Parts A and B still lack extensive long-term care provisions.
This evolving landscape means that staying informed each year is crucial to understand what’s included and what isn’t.
Planning Ahead for Long-Term Care
The earlier you plan, the more options you’ll have. Here are steps you can take now:
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Evaluate your health status and risks: Chronic conditions or family history may signal a higher chance of needing care.
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Review your finances: Consider what you can afford out-of-pocket and whether long-term care insurance is feasible.
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Understand what your Medicare plan does and doesn’t cover: Especially if you’re enrolled in Medicare Advantage.
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Talk to a licensed agent: They can help assess your situation and point you toward suitable resources.
When You Might Need More Than Medicare Offers
You may need more comprehensive long-term care if:
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You develop dementia or another progressive neurological disease
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You have multiple chronic conditions that limit mobility
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You are recovering from a serious accident or illness but don’t fully regain independence
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You’re a caregiver and need support services to help your loved one stay at home
In these situations, the gap between what Medicare provides and what you need becomes more noticeable.
Medicare Isn’t a Long-Term Care Solution—But It’s Still Part of the Picture
While Medicare isn’t designed to pay for extended custodial care, it remains a vital support for short-term skilled needs and hospice care. As benefits continue to evolve in 2025, it’s more important than ever to understand the difference between medical and non-medical care—and to plan accordingly.
For help reviewing your Medicare coverage or to explore other support options, get in touch with a licensed agent listed on this website.
