Nursing home coverage

Nursing home coverage is a form of insurance that pays for long-term care services in licensed nursing facilities. Medicare covers only short-term skilled nursing care–up to 100 days after a qualifying hospital stay–while Medicaid pays for extended stays if you meet strict income and asset requirements.

Private long-term care insurance policies, such as those offered by Genworth or Mutual of Omaha, cover nursing home expenses when policy triggers are met. Standard homeowners or health insurance does not cover nursing home costs.

Average annual nursing home costs in the U.S. Reached $108,405 for a private room in 2023 (Genworth).

Coverage typically includes assistance with activities of daily living (ADLs) like bathing, dressing, and eating. Most policies have an elimination period–usually 30, 60, or 90 days–before benefits begin.

Some plans cap daily reimbursement amounts; for example, many pay up to $150–$300 per day for care. Pre-existing condition exclusions often apply for up to six months after policy start date, according to a report from the Insurance Information Database.

Premiums vary by age and health status; a healthy 55-year-old pays about $2,500 per year for $165/day coverage (AALTCI).