Does Medicare Cover Custodial Care?
Short answer
Original Medicare generally does not cover long-term custodial care when help with activities of daily living or supervision is the only care needed.
Coverage
A person receiving custodial care can still have separate Medicare-covered physician visits, hospital care, skilled therapy, DME or other medical services when those services independently meet Medicare requirements.
Not Automatic
Bathing, dressing, eating, toileting, supervision and similar personal-care assistance do not become Medicare-covered simply because they are medically useful or needed for a long time.
Costs And Ma
Other payers such as Medicaid, long-term-care insurance, veterans benefits or private funds may be relevant. Any Medicare Advantage supplemental support is plan-specific.
Practical Example
Medicare may cover a doctor’s visit for a nursing-home resident but not the resident’s ongoing room, board and custodial assistance solely because they need help with daily activities.
Questions to verify
- Is the service skilled medical care or custodial assistance?
- Is another payer responsible for long-term support?
- Does my MA plan offer any current supplemental benefit?