Does Medicare Cover Custodial Care?

Medicare Benefits Solutions
Oct 11, 2021

The Administration for Community Living (ACL) estimates that “at some point in our lives, about 60 percent of us will need assistance with things like getting dressed, driving to appointments, or making meals.”

But it’s difficult to project the level of care you will need, and long-term care vernacular bandied about in the healthcare community can be confusing. A good first step is to learn the distinction between different types of care so you can develop a plan suitable for your needs and budget.

Custodial care 

Long-term care can be described as a wide range of services and support you may need to address your personal care needs. Most long-term care is assistance with the basic personal tasks of everyday life. Custodial care is a type of long-term care, defined by Medicare as “non-skilled personal care, like help with activities of daily living.” 

Custodial care activities include:

  • Bathing
  • Dressing
  • Eating
  • Transferring to or from a chair or bed
  • Using the bathroom

Caregivers may be family or hired aides, helping you either at home or in a facility. This support does not require professional medical skills. Generally, people receiving custodial care need it long-term.

Custodial care is generally not covered by Medicare, Medigap, or Medicare Advantage plans. However, you may be eligible for long-term non-medical care if you have Medicaid. You can also research long-term care insurance sold by private insurance companies.  

Skilled nursing care

In contrast to custodial care, skilled care is for short-term medical conditions delivered by licensed medical professionals, usually in a skilled nursing facility (SNF). You may qualify for Medicare coverage of SNF inpatient care if your physician certifies that it is medically necessary.

Medicare coverage for a skilled nursing facility includes:

  • Semi-private room
  • Meals
  • Skilled nursing services (not custodial care)
  • Physical therapy

Generally, the SNF stay must follow a medically necessary inpatient hospital stay of at least three days. If you meet the criteria, Medicare covers up to 100 days. Coinsurance applies after day 20.

Home health services

Medicare coverage also includes home health services. To qualify, your doctor must perform a face-to-face evaluation, determine that you are homebound, certify that home health services are medically necessary and order the services through a Medicare-certified home health agency.

Home health covered services include:

  • Skilled nursing care
  • Physical therapy
  • Speech-language pathology
  • Occupational therapy
  • Home health aides (no homemaker or custodial services)

Cost of long-term care

Results of Genworth’s 2020 cost-of-care survey reveal the following national median costs of various forms of care: 

  • Assisted living facility: $51,600
  • Homemaker services like cooking and cleaning: $53,768
  • Home health aide for bathing and dressing: $54,912
  • SNF semi-private room: $93,075

Prices vary widely from one state to another. Long-term care is costly, but there are organizations you can access to help you determine an approach that works best for you and your family. 

Got questions?

Call a licensed sales agent at

877-406-1753 or TTY 771

Mon – Fri 5am – 6pm PT | Sat 5am – 5pm PT | Sunday   Closed

Send us a message

We aim to reply within 24 hours.

    Medicare Benefits Solutions is a non-government website. This is a solicitation for insurance. By submitting information on this site, I am providing my written consent for Medicare Benefits Solutions, herein after referred to as “Medicare Benefits”, which is a brand operated by HealthCompare Insurance Services Inc., its sales agents, or affiliates to contact me (even if I’m on a state or national do not call registry) at the phone number or email address listed to provide me with quotes or information about Medicare Advantage, Medicare Supplement, and Medicare Part D plans. I further consent to such calls or texts sent via autodialer, automated technology, prerecorded message and/or artificial voice. I understand my consent is not a condition of purchase and that I can revoke my consent at any time via Additional charges may apply to SMS, call, or Internet usage depending on your data providers.

    Find a plan

    Get plan recommendations

    Compare your current Medicare plan to our recommendations – then choose the plan that gives you more of the things you want.

    Find a new Medicare plan

    Click here to find out more

    Get a plan recommendation based on what's important to you.