How to Pay for Skilled Nursing Care: Medicare & Medicaid Guide

Cost is one of the first questions families ask when exploring skilled nursing care — and it’s one of the most confusing. Medicare, Medicaid, private insurance, out-of-pocket costs — navigating all of it while also managing a loved one’s health crisis is genuinely overwhelming.
This guide breaks it down clearly and simply. At Carriage Town Skilled Nursing & Rehabilitation Center in Amesbury, MA, we accept Medicare, Medicaid, and most major insurance plans — and our admissions team is here to walk you through every step.

Option 1: Medicare

Medicare is federal health insurance for adults 65 and older. It covers skilled nursing care — but only under specific conditions.
To qualify for Medicare skilled nursing coverage:

• • Your loved one must have had a qualifying hospital stay of at least 3 consecutive days
  • They must be admitted to a Medicare-certified skilled nursing facility within 30 days of that hospital stay
  • They must require skilled nursing or therapy services — not just custodial care

What Medicare covers:

• • Days 1–20: 100% of approved costs covered
    
  • Days 21–100: A daily copay applies (reviewed annually — check medicare.gov for current amounts)
    
  • Day 101+: Medicare coverage ends — other options must be explored

Medicare does not cover long-term custodial care — help with bathing, dressing, and meals when no skilled medical need exists.

Option 2: Medicaid

Medicaid is a joint federal and state program for individuals with limited income and assets. Unlike Medicare, Medicaid can cover long-term custodial care in a skilled nursing facility — making it one of the most important funding sources for seniors who need ongoing residential care.
Key points about Medicaid for nursing home care:

• • Eligibility is income and asset-based — rules vary by state
  • In Massachusetts, MassHealth is the Medicaid program that covers nursing home care
  • There is often a spend-down requirement — meaning a senior must use most of their own assets before Medicaid kicks in
  • Planning ahead with an elder law attorney can help families navigate this process more effectively

Carriage Town accepts MassHealth (Medicaid) and our admissions team can help you understand eligibility and the application process.

Option 3: Private Insurance & Long-Term Care Insurance

Private health insurance may cover short-term skilled nursing stays, similar to Medicare, depending on the policy. Always check with your insurer directly about coverage limits and requirements.
Long-term care insurance is specifically designed to cover extended nursing home and assisted care costs. If your loved one purchased this type of policy years ago, now is the time to review it carefully — benefits, waiting periods, and daily benefit amounts all vary significantly by policy.
Carriage Town works with most major private insurance plans. Our admissions team can verify your coverage before admission.

Option 4: Private Pay (Out-of-Pocket)

When insurance coverage ends or doesn’t apply, families pay out-of-pocket. Skilled nursing facility costs vary by location, level of care, and room type. In Massachusetts, costs are generally higher than the national average.
Private pay residents receive the same high standard of care at Carriage Town — there is no difference in quality based on payment method.

Let Our Admissions Team Help

You don’t have to figure out insurance alone. Carriage Town’s admissions team helps families navigate Medicare, MassHealth, and private insurance clearly — with no jargon, no pressure, and no surprises.
📞 (978) 388-4682 | 📧 info@carriagenh.com | 📍 22 Maple St., Amesbury, MA