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How are we going to pay for this?
Medicare pays for short-term rehab after a hospital stay, hospice, and home health. It does not pay for long-term assisted living or ongoing help with bathing and dressing. Knowing the line between the two saves families from a nasty surprise.
Rules and phone numbers differ by state.Open your state's guide for the local version.
Centers for Medicare & Medicaid Services
Medicare's official helpline answers questions about what Medicare covers, claims, plans and costs, by phone or live chat with a real person.
When to use it: Any time you are unsure whether Medicare will pay for a hospital stay, rehab, hospice or equipment, or need to check a claim.
24 hours a day, 7 days a week, except some federal holidays. TTY 1-877-486-2048
Centers for Medicare & Medicaid Services
Explains when Medicare pays for short-term rehab in a skilled nursing facility: after a 3-day inpatient hospital stay, for daily skilled care, up to 100 days per benefit period. Shows 2026 costs ($0 for days 1 to 20 after the deductible, $217 a day for days 21 to 100).
When to use it: When a parent is being discharged from the hospital to rehab or a nursing home and you need to know if Medicare will pay.
Medicare does not pay for long-term custodial care in a nursing home, and it pays nothing after day 100 in a benefit period.
24 hours a day, 7 days a week, except some federal holidays
Centers for Medicare & Medicaid Services
Explains observation status, the Medicare Outpatient Observation Notice (MOON), and why observation days do not count toward the 3-day inpatient stay Medicare needs before it pays for skilled nursing care.
When to use it: As soon as a parent is in the hospital: ask every day whether they are an inpatient or under observation.
Days under observation, even overnight in a hospital bed, do not count toward the 3-day inpatient stay, which can leave a family paying the full cost of rehab.
24 hours a day, 7 days a week, except some federal holidays
Centers for Medicare & Medicaid Services
Since February 14, 2025, people who were admitted as inpatients and then switched to observation status can ask for a fast appeal through their state's Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), and can still appeal after leaving the hospital.
When to use it: When the hospital gives your parent a Medicare Change of Status Notice (CMS-10868) or you learn their inpatient stay was changed to observation.
Centers for Medicare & Medicaid Services
Explains who qualifies for the Medicare hospice benefit (life expectancy of 6 months or less, choosing comfort care), what it covers at $0, and small costs like up to $5 per prescription.
When to use it: When a doctor suggests hospice or a parent with a serious illness is choosing comfort care over treatment.
Medicare hospice does not pay room and board, so assisted living or nursing home rent still has to be paid another way.
24 hours a day, 7 days a week, except some federal holidays
Centers for Medicare & Medicaid Services
Explains when Medicare pays in full for part-time skilled nursing and therapy at home for someone who is homebound, and what it will not pay for, such as 24-hour care or personal care alone.
When to use it: When a parent is coming home from the hospital or rehab and needs nursing or therapy visits.
Medicare home health does not pay for round-the-clock care or for help with bathing and dressing when that is the only care needed.
24 hours a day, 7 days a week, except some federal holidays
Centers for Medicare & Medicaid Services
Medicare's own plain statement that Medicare and Medigap do not pay for long-term custodial care at home, in assisted living or in a nursing home, and that Medicaid or long-term care insurance are the main alternatives.
When to use it: At the very start, before assuming Medicare will pay for assisted living or a long nursing home stay.
24 hours a day, 7 days a week, except some federal holidays
Centers for Medicare & Medicaid Services
State-run programs that pay Medicare Part B premiums and, for QMB, Medicare deductibles and copays for people with limited income and savings. The page lists 2026 income and resource limits.
When to use it: When a parent's income is modest and Medicare premiums or copays are straining the budget.
Social Security Administration
A federal program that lowers Medicare Part D premiums, deductibles and drug copays for people with limited income and resources; apply online, by phone or at a Social Security office.
When to use it: When prescription costs are adding up and a parent's income is limited.
Mon to Fri 8am to 7pm. TTY 1-800-325-0778
SHIP National Technical Assistance Center (funded by U.S. Administration for Community Living)
Free, unbiased one-on-one counseling from trained local counselors on Medicare coverage, costs, plan choices and help programs.
When to use it: When you need someone neutral to walk through a parent's Medicare, Medigap or drug plan choices or a coverage problem.