Long-Term Care Services Covered by Medicare
Original Medicare will cover some long-term care services, including skilled nursing facility stays and various home care options.
Skilled Nursing Facilities
With Medicare, you can expect to pay the following for skilled nursing care in 2023:
- Days 1-20: Nothing
- Days 21-100: Daily coinsurance payments (up to $200 in 2023)
- After 100 Days: All costs
A Skilled nursing facility (SNF) is able to provide professional staff to monitor, manage, or treat medical/health conditions. SNF professionals include registered nurses, occupational therapists, technicians, speech therapists, and audiologists. Patients who may need care provided at an SNF include those recovering from an acute health condition, injuries requiring physical or occupational therapy, and care that requires the use of intravenous medications.
Home Health Care
Any health care services received in your home, rather than going to a hospital or doctor’s office, qualify as home health care. In 2023 Medicare Parts A and B will cover the following services at home:
- Part-time skilled nursing care
- Physical therapy
- Occupational therapy
- Speech-language pathology
- Medical social services
- Part-time or intermittent home health aide care (only if you’re also getting other skilled services like nursing and/or therapy at the same time)
- Injectable osteoporosis drugs for women
- Durable medical equipment
- Medical supplies for use at home
It’s important to note, however, the difference between home health care and home care. Home health care is medical by nature and is thus eligible for Medicare coverage. Home care, however, is deemed custodial and not usually eligible for Medicare coverage.
Home care services not covered by Medicare include:
- 24-hour-a-day care at your home
- Meal delivery services
- Homemaker services (like shopping, cleaning, and laundry)
- Assistance with activities of daily living (when these are unrelated to your medical care)
Medicare Part A will cover most of the costs associated with hospice, provided a person meets the following conditions:
- Their doctor certifies that they're terminally ill, with six or fewer months left to live.
- They accept palliative care as opposed to care that attempts to cure a condition.
- They sign a statement choosing hospice care over other Medicare-approved treatments.
With Original Medicare, you’ll pay nothing for hospice care; however, the following costs may still remain:
- Copayments for prescription drugs
- 5 percent of the Medicare-approved amount for inpatient respite care
- Room and board if hospice is administered in a facility