Long-Term Care Coverage Calculator
What Medicare and Medicaid actually pay — and what comes out of pocket. Enter your income and care type below.
Nursing Home (Private)
$9,733/mo
national avg
Nursing Home (Semi)
$8,669/mo
national avg
Assisted Living
$4,500/mo
national avg
Home Health Aide
$5,339/mo
national avg
Excludes primary home (up to equity limit), one vehicle, personal belongings
Coverage Estimate
Monthly Care Cost
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Est. Monthly Coverage
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Est. Out-of-Pocket
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vs National Average
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Medicare Coverage
Key facts:
- Medicare does NOT cover long-term custodial care
- Covers up to 100 days in a skilled nursing facility after a 3-day hospital stay
- Days 1-20: Medicare covers 100%
- Days 21-100: You pay a daily copay (approximately $204.50/day in 2025)
- After 100 days: You pay 100% of costs
Medicaid Eligibility Estimate
Annual Out-of-Pocket Estimate
Total Annual Cost
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Est. Annual Coverage
$0
Annual Out-of-Pocket
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Disclaimer: This calculator provides rough estimates only. Medicaid eligibility rules vary significantly by state and change frequently. Asset and income limits shown are approximations. Consult with a Medicaid planning attorney or your state Medicaid office for accurate eligibility determination.
Medicare vs. Medicaid: What Actually Covers Long-Term Care
Medicare covers only short-term skilled nursing care — 20 days at full cost, days 21–100 with a $200/day copay, nothing after day 100. Medicaid covers long-term care but requires spending down assets to $2,000 in most states. Long-term care insurance fills the gap and costs $1,500–$4,000/year at age 55; premiums double by age 65.
Medicare does not cover long-term care. This surprises a lot of families. Medicare will pay for a short-term skilled nursing stay—up to 100 days after a qualifying 3-day hospital admission—but after that, you're on your own. The typical nursing home resident isn't there for rehab after surgery. They're there because they can no longer care for themselves. Medicare doesn't cover that.
What Medicare does cover after a hospitalization: days 1-20 at 100%, then a daily copay of approximately $204.50 for days 21-100 (2025 rate), then nothing. Most families are shocked when the Medicare benefits run out after a few months.
Medicaid is the primary payer for long-term nursing home care in the United States—it covers more than 60% of all nursing home residents. But qualifying requires being nearly broke by most measures. Asset limits run around $2,000 in countable assets in most states (your home, one vehicle, and personal belongings are often exempt). Income limits are typically tied to the nursing facility's cost of care, with most of your income going to the facility and a small "personal needs allowance" kept back.
Planning matters. Medicaid's 5-year look-back period means asset transfers in the five years before applying can trigger penalty periods during which Medicaid won't pay. Families who wait until a crisis to plan often find they have fewer options. A Medicaid planning attorney can help identify legal strategies—spend-down, qualified income trusts, caregiver agreements—before eligibility is needed.
The Coverage Gap
There's a coverage gap that hits middle-income families hardest. Too much in assets to qualify for Medicaid. Not enough to self-fund care for several years at $9,000-$10,000/month. Long-term care insurance was designed to fill this gap, but premiums have risen sharply as insurers misjudged how long people would live and how much care they'd use. Hybrid life insurance/LTC policies have become more common as an alternative.
If Medicaid is the likely end-point, starting Medicaid planning early—ideally 5+ years before care is needed—gives families the most options and preserves the most assets legally possible.
Updated April 2026. Estimates only; consult a Medicaid planning professional for accurate eligibility.