Best Nursing Homes That Will Accept Medicare (2024)

When looking for nursing homes that accept Medicare or Medicaid, it is important to remember that these programs do not cover 100% of the costs for everyone.

Each type of health insurance pays for a different kind of care, and each has specific requirements and eligibility differences you will need to meet in order to qualify.

Keep reading to find nursing homes that accept Medicare and Medicaid, what they pay for, and how to qualify. Enter your ZIP code into our free and easy-to-use tool to start comparing quotes in your area today.

What nursing homes will accept Medicare and Medicaid?

Almost all nursing homes will accept both Medicare and Medicaid. However, most people don’t know the cost will only be covered for short, approved visits. When Medicare stops paying, you’ll need to find other options.

What Medicare Covers

Medicare and Medicaid Nursing Home Coverage

Medicare does cover a limited number of services within nursing homes for patients who meet specific criteria if deemed medically necessary.

Medicare does not cover:

• Long-term custodial care
• Dental care
• Routine eye exams
• Cosmetic procedures
• Hearing aids and related exams
• Routine Podiatry

For eligibility, you are required to enroll in a Medicare plan (Part A, B, or C) and have available days in your benefit period still active. In addition, to enter a Medicare-approved facility within 30 days, you must be a hospitalized inpatient for three or more days for evaluation, unless otherwise waived.

A physician will determine your daily care needs and treat any hospital-related medical condition during the qualified stay.

How much does Medicare cover?

It will depend on the plan you choose and how long the rehabilitation is intended to cover. Medicare only covers a maximum of 100 days and will calculate your rates based on that time period. Once that period is up, your out-of-pocket cost will change.

Medicare Coverage Rates by Days

Since Medicare coverage runs out after 100 days, it’s in best practices to know your long-term options. You may have more coverage with a Medicare Advantage plan offered by a private company. These plans can be either HMO (Health Maintenance Organization) insurance or PPO (Preferred Provider Organization) insurance, and have added benefits.

What does Medicaid cover?

Medicaid nursing home coverages help cover medical costs for people with a limited source of income. However, since income and asset limits will vary by state, most people won’t qualify for Medicaid right away and will need to pay for a nursing home through private insurance or personal funds.

Not all nursing homes accept Medicaid, so it’s always best to check with your facility to determine what they do and don’t cover. If you do qualify for Medicaid, basic long-term health care costs will be covered.

Medicaid does take into account your assets, including bank balances, stocks and bonds, secondary property, and non-primary vehicles.

Unlike Medicare, Medicaid does not impose an official time limit on nursing home stays as long as they’re in a licensed and certified Medicaid nursing facility. In addition, long-term care, skilled nursing (for related medical care), and rehabilitation of illnesses, injuries, or disabilities are all covered under Medicaid.

What Medicaid also covers:

• Nursing services
• Room and board
• Dietary services
• Medically-related social services
• Pharmaceutical services
• Routine hygiene products and assistance
• Dental (routine and emergency dental, up to the state limit)
• Professionally directed activities
• Specialized rehabilitation (for mental illness or disability)

Some Medicaid services are covered, but others are not. Because individual states manage their own Medicaid programs, the extent of coverage depends on your facility’s location.

Medicaid does not cover:

• Private rooms (unless medically necessary)
• Clothing
• Special food (beyond what the facility already prepares)
• Telephone, TV, radio, computers, reading materials, tobacco or alcohol
• Extra grooming products
• Social activities beyond the facility’s activity program
• Special care outside Medicaid-contracted coverage

The federal government does require Medicaid-certified nursing homes to provide minimum services for all patients.

Other Options

You can buy insurance policies that come with long-term health care costs, but rates vary considerably. For example, some will just cover nursing home care, and others will cover adult daycare and medical equipment.

Before buying long-term care insurance, make sure you buy from a reputable and licensed company in your state. Pre-existing conditions may limit your coverage, but veterans, government employees, and other qualifying groups may be eligible for a discount.

How do I find Medicare and Medicaid nursing homes near me?

The best way to answer the questions: ‘how to find nursing homes that accept Medicaid near me?’ would be to start talking to your doctor. Like many service providers, doctors have a vast network of potential nursing homes that are certified locally.

Asking friends or family members who also have elderly family members in nursing homes is another avenue.

Eldercare and Medicare’s websites both have databases that can be utilized when needing out-of-state care (or local) and have amassed an extensive network of providers as well as care facilities.

All 50 states offer Medicare and Medicaid, but nursing home services, costs,  coverages, and eligibility requirements will vary by state.

Best Nursing Homes That Will Accept Medicare: Key Takeaways

Understanding the costs of nursing homes, and what is and isn’t covered under each plan, will help you determine which plan is right for you and your family.

As healthcare costs continue to rise over the next few years, you may wonder how your loved ones will cover the expenses. Medicare and Medicaid are great programs that allow for qualified, skilled care to take care of you or your loved one.

Medicare and Medicaid plan pricing, coverage, and provider networks can change annually, so be sure to review your selections every year for the best rates.

Now that you’ve learned how to find nursing homes that accept Medicare and Medicaid, take the time to enter your ZIP code into our free and easy-to-use tool and start comparing quotes in your area today.

1. https://eldercare.acl.gov/Public/Index.aspx
2. https://www.medicare.gov/care-compare/