What Medicare pays for: hospital, nursing home, hospice, home health and dialysis

Who this guide is for

For people with Medicare and their families who want to know, before or during care, whether Medicare will pay. This guide gives the basic rules of Original Medicare. If you have a Medicare Advantage plan, it covers almost all the same services, but its rules and costs can differ: ask your plan.

The basic rules, by kind of care

Hospital stay (Part A)

Covers inpatient care when a doctor formally admits you with an order and the hospital accepts Medicare: a semi-private room, meals, nursing, and the drugs and supplies for your inpatient treatment. You pay a deductible for each benefit period, and a daily amount from day 61. Care under observation is outpatient care (Part B), even if you stay overnight. See how to choose a hospital.

Skilled nursing facility (Part A)

Covers a short stay for daily skilled nursing or therapy after a qualifying inpatient hospital stay of at least 3 days in a row. The day you leave the hospital does not count, and neither does time under observation or in the emergency room before you were admitted. You generally must enter the facility within 30 days of leaving the hospital. Up to 100 days in each benefit period. See how to choose a nursing home.

Hospice (Part A)

Covers comfort care when your hospice doctor and your regular doctor (if you have one) certify that you are terminally ill, with a life expectancy of 6 months or less, and you choose comfort care instead of treatment to cure the illness. Two 90-day periods, then an unlimited number of 60-day periods. You pay nothing for hospice care from a Medicare-approved hospice, except a small copayment for some medicines and a small share of the cost of inpatient respite care. Room and board are not covered. See how to choose hospice care.

Home health care (Part A and/or Part B)

Covers part-time or intermittent skilled nursing and therapy at home when you are homebound (leaving home takes a lot of effort), a doctor or other provider such as a nurse practitioner sees you in person and orders the care, and a Medicare-certified home health agency gives it. You pay nothing for covered home health services. See how to choose a home health agency.

Dialysis (Part B)

Covers outpatient dialysis at a Medicare-certified dialysis facility or at home, home dialysis equipment and supplies, and home dialysis training. You usually pay 20% of the Medicare-approved amount after the Part B deductible. See how to choose a dialysis center.

Not covered

Long-term custodial care (help with bathing, dressing, eating) when it is the only care you need, in a nursing home or at home; 24-hour care at home; and room and board in assisted living. See how people pay for long-term care.

Questions to ask when you call or visit

• In the hospital: am I an inpatient, or an outpatient under observation? Ask every day you stay.
• Before going to a skilled nursing facility: did I have a qualifying inpatient stay of at least 3 days in a row? Will Medicare or my plan cover this stay?
• Is this provider certified by Medicare, and is it in my plan’s network?
• What will I pay, and what is not covered? Can I have it in writing?
• If my coverage ends, what notice will I get, and how do I appeal?

Warning signs

• You are told Medicare will pay for a long nursing home or assisted living stay when you only need help with daily activities. Medicare does not pay for long-term custodial care.
• You spent several nights in the hospital “under observation”. Those days do not count toward the 3-day inpatient stay that Original Medicare requires for skilled nursing facility care.
• Someone offers free equipment, tests or services in exchange for your Medicare number.

Costs and who pays

Original Medicare has two parts for this care: Part A (hospital insurance) for inpatient hospital stays, skilled nursing facility care and hospice, and Part B (medical insurance) for doctor and outpatient care, dialysis and medical equipment. Home health care can be covered by either part.

A benefit period starts the day you are admitted as an inpatient in a hospital or skilled nursing facility, and ends when you have had no inpatient hospital care (or skilled care in a facility) for 60 days in a row. There is no limit to the number of benefit periods.

Medicare Advantage plans may have different rules; for example, a plan may waive the 3-day hospital stay for skilled nursing facility care, or charge copayments during the first 20 days.

Medicaid is run by each state with federal rules, for people with limited income and savings. Rules, covered services and waiting lists differ by state: ask your state Medicaid agency.

In general terms only. Deductibles, coinsurance and other amounts change every year, and Medicaid rules differ by state: check Medicare.gov, call 1-800-MEDICARE or your state Medicaid agency, and ask your plan.

How to complain or get help

• Care ending too soon: in the hospital you get the notice “An Important Message from Medicare About Your Rights”; in a skilled nursing facility, home health or hospice you get a “Notice of Medicare Non-Coverage” at least 2 days before covered services end. Both explain how to ask the BFCC-QIO for a fast appeal. See leaving the hospital.
• Quality of care: the BFCC-QIO for your state reviews complaints about the quality of care you got for a Medicare-covered service.
• Medicare: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, free, with help in Spanish and other languages.

Find care on US Patient Guide

Common questions

Sources

• Inpatient hospital care: what Medicare covers (Medicare.gov)
• Inpatient or outpatient hospital status affects your costs (Medicare.gov)
• Skilled nursing facility (SNF) care: what Medicare covers (Medicare.gov)
• Hospice care: what Medicare covers (Medicare.gov)
• Home health services: what Medicare covers (Medicare.gov)
• Dialysis services and supplies: what Medicare covers (Medicare.gov)
• Long-term care: what Medicare covers (Medicare.gov)
• Your Medicare Benefits (Medicare booklet 10116, PDF)
• Fast appeals: if your care is ending too soon (Medicare.gov)
• Medicare.gov in Spanish

Written in plain language by US Patient Guide from the official sources above, November 11, 2026. The facts on each provider page come from the official data shown on that page, with its date. Not medical advice.