Nursing homes have become an essential part of care for many elderly and disabled individuals who require assistance with daily living or medical needs. However, the cost of nursing home care has been rising steadily, raising concerns about whether Medicare, the federal health insurance program primarily for people aged 65 and older, can keep up with covering these expenses.
The average cost of nursing home care in 2025 is approximately $10,965 per month for a private room and about $9,555 for a semi-private room. This translates to an annual cost exceeding $110,000, which is a significant financial burden for many families. Costs vary widely depending on the state, the facility’s quality, and the level of care required. For example, nursing homes in New York can cost around $15,000 per month, while in Texas, the average is closer to $6,200 per month. These costs include room, board, and medical care, but the exact services and amenities can differ greatly from one facility to another.
Medicare’s coverage of nursing home care is limited and often misunderstood. Medicare Part A, which covers hospital insurance, does pay for some skilled nursing facility (SNF) care, but only under strict conditions. To qualify for Medicare coverage of skilled nursing care, a patient must have had a qualifying hospital stay of at least three days, be admitted to a Medicare-certified skilled nursing facility, and require daily skilled nursing or rehabilitation services. Medicare Part A covers the full cost for the first 20 days of skilled nursing care, then requires a daily copayment from days 21 to 100, and after 100 days, the patient is responsible for all costs. This coverage is intended for short-term rehabilitation or recovery, not long-term custodial care.
Long-term care, which includes assistance with activities of daily living such as bathing, dressing, and eating, is generally not covered by Medicare. This type of care is often what nursing homes provide for residents who cannot live independently. Because Medicare does not cover long-term nursing home care, many individuals and families face substantial out-of-pocket expenses or must rely on other sources of funding such as Medicaid, long-term care insurance, or personal savings.
Medicaid, a joint federal and state program, is the primary payer for long-term nursing home care for those who qualify based on income and asset limits. However, Medicaid eligibility rules are strict, and many people spend down their assets to qualify. Even with Medicaid, the availability and qualit
