One of the most common Medicare misconceptions is that it covers long-term nursing home care. Understanding what Medicare actually covers — and the significant gaps — is essential for Florida seniors planning for their future care needs.
What Medicare Covers: Skilled Nursing Facility Care
Medicare covers skilled nursing facility (SNF) care under specific conditions. You must have a qualifying hospital stay of at least 3 consecutive days (not counting the day of discharge). The SNF care must be for a condition related to your hospital stay. The care must be "skilled" — meaning it requires the expertise of licensed nurses or therapists.
Coverage is time-limited: Days 1–20 are covered at 100% (after the Part A deductible). Days 21–100 require a daily coinsurance of $209.50 in 2026. After day 100, Medicare pays nothing.
What Medicare Does NOT Cover: Custodial Care
Medicare does not cover custodial care — help with activities of daily living like bathing, dressing, eating, and toileting when no skilled care is needed. This is what most people think of as "nursing home care." If you need long-term custodial care, Medicare will not pay for it.
Who Pays for Long-Term Care in Florida?
Long-term custodial care in Florida is paid primarily through three sources: private pay (your own savings), Medicaid (for those who qualify financially), and long-term care insurance. The average cost of a private room in a Florida nursing home is approximately $9,000–$11,000 per month in 2026.
Medicaid and Long-Term Care in Florida
Florida Medicaid covers long-term nursing home care for those who meet income and asset requirements. Qualifying for Medicaid nursing home coverage requires spending down assets to program limits. Medicaid planning with an elder law attorney is advisable for seniors who anticipate needing long-term care.
Planning Ahead
The best time to plan for long-term care costs is before you need them. Options include long-term care insurance, hybrid life/LTC policies, and Medicaid planning strategies. A licensed insurance agent can help you evaluate long-term care insurance options alongside your Medicare coverage.
Call (435) 612-1009 for a comprehensive Medicare and long-term care planning consultation.