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When someone needs a nursing home and you can’t pay for it: what Medicare covers, Medicaid, a spouse at home, being told to leave, and who to ask
For anyone who needs a nursing home or assisted living, or is already in one, and cannot pay for it, and for the husband, wife, daughter, son or friend doing the paperwork. This page cannot find a bed, and it does not know what Medicare, your state, a plan, VA or a facility will decide. It passes on, by name and date, what the federal Medicare and Medicaid websites, one federal rule, Veterans Affairs, the U.S. Administration for Community Living and the National Institute on Aging say: the short stay Medicare covers and the long stay it does not, what Medicaid must cover, what is protected for a spouse at home, what Medicaid.gov says about the house and the estate, what a nursing home may not ask you to sign, when it may make a resident leave, and who stands up for residents. It states no price and names no facility or company.
A word with a dotted line under it, like this, opens its official definition, quoted from a U.S. government glossary.
Before anything else
- Anyone in danger right now, in a home or anywhere else: call 911. This line is ours.
- Medicare covers a short stay, not a long one. Medicare.gov says Part A limits skilled nursing facility coverage to 100 days in each benefit period, and that Medicare generally does not cover long-term nursing home stays.
- In the hospital now? Medicare.gov says time under observation does not count toward the 3 inpatient days that have to come first, and to always ask your doctor or hospital staff if Medicare will cover the stay.
- Told that Medicare coverage is ending? Medicare.gov says to follow the instructions on the “Notice of Medicare Non-Coverage” no later than noon the day before the termination date listed on the notice.
- Medicaid: Medicaid.gov says nursing facility services are required to be provided by state Medicaid programs for individuals age 21 or older who need them, and that states may not make them subject to waiting lists. Who is eligible differs by state, and we read no state’s rules.
- Told a resident has to leave? A federal rule says the notice must be in writing, generally at least 30 days before, with a statement of appeal rights and the phone number of the Long-Term Care Ombudsman.
- Asked to sign as the person who pays? The same rule says a facility must not request or require a third party guarantee of payment as a condition of admission.
- None of this says anything bad about you. If the weight turns into thoughts of suicide, call or text 988 at any hour.
- This page saves nothing. There is nowhere on it to type, and it loads no analytics. Your browser still keeps a history.
More help
- Staying at home with help instead: When you need help at home and can’t pay for it.
- A resident who is being hurt, neglected or robbed: Elder abuse.
- Helping someone else: Caring for someone.
- Memory loss: Dementia.
- Getting older: Getting older.
- Your state’s Medicaid agency: Your state’s offices.
- A lawyer you do not pay: Free legal help.
- If they served: Veterans.
- A serious illness, and what the person wants: End of life.
- Equipment, like a wheelchair or a hospital bed: When you can’t afford medical equipment.
- A bill that already came: Medical bills.
- Someone offering to “protect” assets for a fee: Scam check.
- Before a hard phone call: Call script.
- Right now: Get help now.
- All our free tools.
This page and its wording were written with AI (Claude) for Scarlet Beast (our AI policy). No doctor, nurse, lawyer or benefits counselor has reviewed it. The facts were read on October 8, 2026 on each source’s own pages: Medicare’s coverage pages “Skilled nursing facility care”, “Nursing home care” and “Long-term care” and its page “Fast appeals”; Medicaid.gov’s “Nursing Facilities”, “Spousal Impoverishment” and “Estate Recovery”; section 483.15 of Title 42 of the Code of Federal Regulations (version of October 1, 2026) on eCFR.gov; the Administration for Community Living’s “Long-Term Care Ombudsman Program” (last modified 10/21/2024); Veterans Affairs’ “Community Living Centers (VA Nursing Homes)” (last updated March 27, 2026), “Community Nursing Homes” (May 30, 2025), “State Veterans Homes” (March 21, 2025) and “Aid and Attendance benefits and Housebound allowance” (May 8, 2026); and the National Institute on Aging’s “Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care”, “How To Choose a Nursing Home or Other Long-Term Care Facility” and “Paying for Long-Term Care” (each content reviewed October 12, 2023). We did not read any state’s Medicaid program, its income or asset limits, its rules on money or property given away before applying, its bed-hold days or its rules for assisted living; any Medicaid or Medicare Advantage plan; long-term care insurance; the federal rule on residents’ rights (42 CFR 483.10) or the Medicaid appeal rules; or VA’s eligibility rules, copays or pension amounts, and the page says so where it matters. We state no price, daily rate, deductible, limit or allowance, and we name no facility, company or charity. We pass on no statistics and no ratings. We called none of the phone numbers. Sentences marked “ours” are our own.