Does Medicare pay for nursing homes?

Medicare covers skilled nursing facility care only after a qualifying 3-day inpatient hospital stay, and only for up to 100 days. Custodial care — help with daily activities like bathing and eating — is not covered by Medicare at all.

When should I buy long-term care insurance?

The optimal window is ages 55-65. Buying in your late 50s balances premium affordability against the risk of being declined for health reasons. Premiums at age 55 are roughly half what they are at age 65.

What assets are protected from Medicaid spend-down?

Exempt assets typically include your primary residence (with conditions), one vehicle, personal belongings, and irrevocable funeral contracts. Rules vary by state. Medicaid has a 5-year look-back period.

How much does assisted living cost in 2026?

The national average is approximately $5,100/month ($61,200/year). Costs range from $3,200/month in Missouri to $7,500+/month in California, Hawaii, and New York. Memory care units run 20-30% higher.

Long-Term Care Planning Guide 2026 — Costs, Insurance, and Medicaid

Long-term care is one of the largest unplanned expenses in retirement. The average nursing home cost in 2026 is $9,000-$10,500/month for a private room.

2026 long-term care cost benchmarks (national averages):

Care Setting	Monthly Cost	Annual Cost
Home health aide (44 hrs/week)	$6,200	$74,400
Adult day care	$1,900	$22,800
Assisted living facility	$5,100	$61,200
Nursing home (semi-private)	$9,000	$108,000
Nursing home (private room)	$10,500	$126,000
Memory care	$6,200	$74,400

Source: Genworth Cost of Care Survey, 2025 data with 2026 estimates.

Who Pays? The Coverage Gap

Medicare: Covers only short-term skilled nursing after a qualifying hospital stay (up to 100 days). Does NOT cover custodial long-term care.
Medicaid: Covers long-term care for those meeting income and asset thresholds. Requires spend-down to eligibility limits (typically $2,000 in countable assets).
Long-term care insurance: Covers a defined daily benefit. Most policies have a 90-day elimination period.
Personal savings: The default for most Americans — a 3-year nursing home stay costs $300,000+.

Care Costs by Setting

Senior Housing Options

Insurance Options

Medicaid Planning

Family Caregiving

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Written by WealthVieu

WealthVieu researches and writes data-driven personal finance guides using primary sources including the IRS, Bureau of Labor Statistics, Federal Reserve, and Census Bureau.

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