What Medicare pays for, and what it does not, when a parent needs care

The sentence that explains most surprises

Medicare pays for medical care: hospitals, doctors, therapy, and skilled nursing for a while. It does not pay for custodial care, which is help with bathing, dressing, eating, and getting around when that is the main thing needed. Medicare's own page says it does not pay for long-term care in a nursing home, in assisted living, or at home. Almost every family hears this for the first time in a hospital hallway.

After a hospital stay: skilled nursing (rehab)

Under Original Medicare, a short-term stay in a skilled nursing facility can be covered when the person was a hospital inpatient for at least three days in a row (not counting the day they leave) and needs daily skilled care. Time in the hospital under observation does not count, so ask the hospital which one it is.

For 2026: up to 100 days per benefit period. Days 1 through 20, you pay nothing after the $1,736 Part A deductible. Days 21 through 100, you pay $217 per day. After day 100, you pay everything. These numbers change every January. Medicare Advantage plans cover the same benefit but can require prior approval and set their own copays.

At home: home health

Medicare can pay for part-time skilled nursing and therapy at home from a Medicare-certified agency when a doctor orders it and the person has trouble leaving home. Medicare's cost page lists home health at $0 for covered services. Some aide help can be included while skilled care is going on. It does not cover an aide for daily help on its own, meals, or round-the-clock care. Durable medical equipment such as a walker or hospital bed is usually covered at 80 percent after the Part B deductible, which is $283 in 2026.

At the end of life: hospice

Medicare Part A covers hospice when a hospice doctor and the regular doctor certify a life expectancy of six months or less and the person chooses comfort care over treatment meant to cure. Coverage runs in two 90-day periods and then unlimited 60-day periods, with recertification. You pay up to $5 for each prescription for pain or symptoms and 5 percent of the cost of inpatient respite care. Medicare does not pay the room and board of a nursing home or assisted living while someone is on hospice.

The recurring costs

Most people pay a Part B premium each month; the standard amount in 2026 is $202.90, taken out of the Social Security check. People with limited income can get help with that premium through a Medicare Savings Program. See our article on help with Medicare costs.

Questions for the hospital or the plan

• Is this admission inpatient or observation?
• How many days of rehab are covered, and what does day 21 cost us?
• Does the plan need prior authorization for the rehab facility or home health?
• When coverage ends, what is the private daily rate?
• Has anyone talked to us about hospice or palliative care?

Free help reading the fine print

HIICAP is New York's free Medicare counseling program, staffed in each county Office for the Aging: 1-800-701-0501. Counselors compare plans, explain a bill, and help with appeals. Nobody sells anything.