How much does Medicaid pay for nursing home care?
- Medicaid pays nearly the full cost of nursing home care for residents who qualify, making it the largest payer of long-term institutional care
- The resident contributes almost all monthly income toward the bill, keeping only a small personal needs allowance, and Medicaid covers the remainder
- Eligibility is means-tested; in most states in 2026 an individual must have income under about $2,982 a month and countable assets under $2,000
- Applicants must also need a Nursing Facility Level of Care and generally clear a five-year look-back on asset transfers
Medicaid paid 44% of the $147 billion the United States spent on institutional long-term care in 2023. Eligibility rules vary by state, detailed in our Medicaid long-term care research.
Medicaid can pay nearly the full cost of nursing home care for eligible residents, but applicants must meet strict financial, medical and asset-transfer rules.
How long does Medicare pay for nursing home care?
- Medicare pays for up to 100 days of skilled nursing facility care per benefit period, and only after a qualifying three-day inpatient hospital stay
- It covers only short-term skilled care like rehabilitation or wound care, never long-term custodial help with daily activities
- In practice, Medicare-covered skilled stays averaged about 31 days in a recent year, far below the 100-day maximum
- Once skilled care is no longer needed, Medicare coverage ends, even if days remain
This is the gap that pushes families toward Medicaid for any extended stay. Medicare is designed for recovery, not permanent residence, as explained in our Medicare senior care research.
Medicare can cover up to 100 days of skilled nursing facility care, but it is designed for short-term recovery, not long-term nursing home residence.
How long will Medicaid pay for nursing home care?
- Medicaid has no day limit for nursing home care; it pays for as long as the resident remains financially eligible and continues to need that level of care
- This is the key difference from Medicare, which stops at 100 days, because long-term nursing home stays can extend well beyond Medicare’s short-term skilled-care benefit
- Coverage continues year after year for many residents, which is why Medicaid funds the majority of long stays
- Eligibility is reviewed periodically, so residents must stay within the income and asset limits to keep coverage
Because long-term nursing home stays can run for years, the absence of a day cap matters enormously. The full cost picture appears in our nursing home cost research.
What percentage of nursing home residents are on Medicaid?
- 63% of nursing home residents have Medicaid as their primary payer, or more than six in ten
- That share has held steady across recent years among the roughly 1.2 million people living in nursing facilities
- About 14% of residents have Medicare as their primary payer, since Medicare covers just short stays
- The remaining 23% pay through private insurance, out of pocket or other sources
| Primary payer |
Share of nursing home residents |
| Medicaid |
63% |
| Medicare |
14% |
| Other (private insurance, out of pocket) |
23% |
Many residents enter paying privately or with Medicare, then shift to Medicaid once savings run low. This pattern is why Medicaid funds the majority of long nursing home stays nationwide.
Medicaid is the primary payer for 63% of nursing home residents, far more than Medicare, because Medicare mainly covers short skilled stays.
How long can you stay in a skilled nursing facility?
- Under Medicare, a skilled nursing stay is limited to 100 days per benefit period, though a resident can stay longer by paying privately or through Medicaid
- A benefit period begins on hospital or facility admission and ends after 60 consecutive days with no inpatient or skilled care
- Once a benefit period ends, a new one can begin, refreshing the 100-day allowance for a future skilled stay
- There is no lifetime limit on benefit periods, so the 100 days can renew across separate episodes of care
The benefit-period reset is widely misunderstood, but it means skilled coverage is tied to episodes, not a single lifetime cap. The distinction matters most for residents who recover, leave, then return after a later hospitalization.
How many skilled nursing days does Medicare cover?
- Medicare covers a total of 100 skilled nursing days per benefit period, split into two cost tiers
- The first 20 days are fully covered at $0 per day after any qualifying hospital deductible
- Days 21 through 100, up to 80 additional days, are covered except for a daily coinsurance the resident owes
- Beyond day 100, Medicare pays nothing, and the resident is responsible for the entire cost
| Skilled nursing days |
Medicare coverage (2026) |
| Days 1 to 20 |
Fully covered, $0 per day |
| Days 21 to 100 |
Covered minus $217 a day coinsurance |
| Days 101 and beyond |
Resident pays all costs |
Because average Medicare-covered stays are far below the 100-day maximum, the first 20 fully covered days matter most for many families. The structure resets with each new benefit period.
Medicare covers skilled nursing in tiers, with full coverage for days 1 to 20, $217 per day coinsurance for days 21 to 100 and no coverage after day 100.
What is the Medicare skilled nursing coinsurance per day?
- For 2026, the skilled nursing coinsurance is $217 a day for days 21 through 100, up from $209.50 in 2025
- This amount equals one-eighth of the annual Part A hospital deductible, which is $1,736 in 2026
- Over the full 80 coinsurance days, the cost can reach about $17,360 out of pocket
- Many Medigap policies cover this coinsurance in full, and Medicaid may cover it for eligible dual-eligible residents
| Year |
Skilled nursing coinsurance (days 21 to 100) |
| 2025 |
$209.50 per day |
| 2026 |
$217.00 per day |
Without supplemental coverage, this daily charge adds up quickly, which is why so many families plan ahead with Medigap or explore Medicaid eligibility.
This research is for informational purposes only and is not financial, legal, tax or medical advice. Coverage rules, eligibility limits and cost figures change and vary by state and circumstance. Confirm current figures with Medicare, your state Medicaid office or a qualified professional before making decisions.
Sources and additional resources
Source note: The 2026 skilled nursing coinsurance of $217 a day, the prior $209.50 in 2025 and the $1,736 Part A deductible come from the CMS 2026 premiums and deductibles fact sheet. The 100-day limit, the 20 fully covered days and the three-day qualifying stay come from Medicare, and the five-year look-back from a CMS transfer-of-assets backgrounder.
Medicaid as primary payer for 63% of residents, Medicare for 14% and other payers for 23% come from KFF’s 2025 nursing facility characteristics data. The 1.2 million residents and Medicaid’s 44% share of the $147 billion spent on institutional long-term care in 2023 also come from KFF.
The Medicaid income limit of about $2,982 a month (300% of the federal SSI rate) and the $2,000 countable-asset limit come from KFF’s 2026 non-MAGI eligibility data, and both vary by state. The average Medicare-covered skilled stay of about 31 days comes from MedPAC’s March 2026 analysis.
Raya’s Paradise provides residential assisted living, memory care, hospice support, short term respite care and in-home care across Southern California, an option many families consider when a nursing home is more care than a loved one needs. Families weighing the next step can tour assisted living in Los Angeles and assisted living in Orange County.
