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Most people don’t expect the emotional toll a nursing home move can take until they’re in the middle of it. For seniors, the shift is rarely just physical. They often feel the burden of losing routines, privacy, and a deep sense of independence. Families are left juggling big emotions while also trying to answer practical questions. One of these commonly asked questions is, “Does Medicare pay for nursing home care?”
Medicare generally does not pay for long-term "custodial care,” which is help with daily living, like bathing or dressing. But, Medicare Part A does cover a limited stay in a Skilled Nursing Facility (SNF) if it follows a qualifying hospital stay. People hear the words “not covered” and assume nothing is, but Medicare Part B continues to play a role long after the admission paperwork is completed.
Medicare does cover mental health support inside a nursing home, and that coverage matters more than many families realize. For seniors adjusting to a completely new routine, access to regular therapy sessions with a licensed professional helps residents work through grief, manage depression or anxiety, and keep a sense of who they are, even as familiar parts of life fall away.
Understanding Medicare’s Role in Nursing Home Care
Paying for nursing home care often comes with a steep learning curve. One of the most important distinctions to understand is how Medicare separates short-term medical recovery from long-term daily living support.
Short-Term Recovery: The Role of Medicare Part A
Medicare Part A is specifically designed for rehabilitation and recovery. If a senior is admitted to a hospital for at least three days and then requires specialized care, such as physical therapy after surgery, Medicare covers a Skilled Nursing Facility stay for a limited window.
This coverage lasts for up to 100 days per benefit period, provided the patient needs "skilled" medical treatments to improve or maintain their condition. While the first 20 days are covered at 100%, it is important to plan for the remaining time; for days 21 through 100 in 2026, there is a daily coinsurance of $217.00.
The "Gap": Understanding Custodial Care
As a senior settles into a facility, their needs often shift from medical recovery to help with the rhythms of daily life, like getting dressed, taking a bath, or enjoying a meal. In the world of insurance, this is called custodial care.
The hard truth is that Medicare does not cover this type of long-term assistance. It is a significant gap. This reality often leaves families scrambling to figure out a plan, as these residential costs must be paid out-of-pocket unless there is a long-term care insurance policy or Medicaid eligibility in place. Facing such a heavy financial strain is difficult, especially when you are already navigating the emotional weight of a loved one’s transition.
"Medical Necessity" Follows the Patient
Even if your loved one has moved past those first 100 days and is now paying for their own "room and board," Medicare doesn't just disappear. While the family might be responsible for the cost of the bed, Medicare Part B continues to provide a safety net for medically necessary services.
There is a small but important silver lining to keep in mind. As long as a service is required to treat or manage a health condition, Medicare will cover it. This means your loved one never loses access to the specialized care and professional support that truly help them thrive. They still have their regular doctor visits. They can still get specialized medical equipment. Perhaps most importantly, they still have mental health support.
When you look past the "room and board" costs and focus on the medical care your loved one actually needs, it opens the door to the high-quality support they deserve. There is a deep sense of relief in knowing your family doesn't have to carry the weight of every specialist visit alone. By letting Medicare help handle the clinical side of things, you’re free to step back into your most important role—simply being a daughter, a son, or a spouse again.
Does Medicare Pay for Mental Health Care in a Nursing Home?
Medicare Part B covers outpatient mental health services for residents regardless of how long they have lived in the facility.
How Psychologist Visits are Covered
Because mental health is critical to geriatric care, Medicare covers visits from licensed clinical psychologists who see residents directly in the nursing home. This eliminates the stress of transportation and allows seniors to receive care in privacy.
Once the annual Part B deductible is met—which is set at $283 in 2026—Medicare typically steps in to cover 80% of the approved cost for mental health services. For many families, the remaining 20% can feel like another looming expense, but this is where supplemental coverage makes a significant difference.
If your loved one has a Medigap policy, that secondary insurance often picks up the remaining 20% coinsurance. This "wraparound" support effectively bridges the financial divide, often resulting in little to no out-of-pocket cost for regular therapy sessions. It is a relief to know that the focus can remain entirely on their emotional healing rather than on the cost of each visit.
What Services Are Included?
To help seniors find their footing during this transition, Medicare covers specialized emotional support, including:
- Psychiatric Diagnostic Evaluations: To identify issues like anxiety or cognitive changes.
- Annual Depression Screenings: Covered at 100% once per year as a preventive service.
- Individual Psychotherapy: Sessions to process grief or cope with new medical diagnoses.
The Importance of Mental Health Support for Residents
It is easy to see when a resident needs help walking or eating. Invisible struggles, like isolation or loneliness, are much harder to spot. For many, the move triggers "Relocation Stress Syndrome." This is a real, taxing condition where the shock of transition can lead to heightened confusion or accelerated cognitive decline.
Nursing staff work tirelessly to manage physical safety. Families do everything they can to provide love. Still, there is a specific kind of emotional support only a professional psychologist can provide.
Regular therapy sessions offer residents a rare gift: a quiet space to look back. Seniors can "reminisce" and gently process the grief that follows a massive life change. A psychologist acts as a gentle bridge to a "new normal." They help residents navigate the social anxieties of a new environment. This builds the confidence needed to step out of a room, make new friends, and join in on facility life.
Find Quality Care That Goes Beyond Physical Health
While the answer to "Does Medicare pay for nursing home care?" is often complicated regarding room and board, mental health coverage remains a comforting constant. Utilizing Medicare Part B for psychologist visits ensures that residents don't have to navigate heavy life transitions alone. It provides a safety net for those who need professional support to process grief, manage anxiety, or simply find their footing again.
For facility administrators, the goal is always to provide a home, not just a bed. Pacific Coast Psychology has a team of licensed psychologists who work directly within nursing homes and skilled nursing facilities across California. We meet residents exactly where they are, bringing evidence-based therapy right to the bedside. By working together, we make sure that a resident's emotional health is never just an "extra.” Instead, it becomes a natural, core part of their daily care from the very first day they arrive.
Are you ready to bring specialized mental health support to your facility? Contact Pacific Coast Psychology today to learn how partnering with our team can support your residents' emotional well-being.
Medicare and Nursing Home Care FAQs
Q: What is custodial care?
A: Custodial care includes things like getting dressed, taking a shower, moving safely from bed to chair, or even just having someone nearby to lend a hand. These are also called Activities of Daily Living.
Q: Does Medicare pay for nursing home care?
A: While it does not pay for long-term custodial care (room and board), what Medicare will pay for in nursing homes are up to 100 days of short-term rehabilitation per benefit period, with the first 20 days fully covered and a $217.00 daily coinsurance for days 21–100 in 2026. For long-term residents, Medicare Part B continues to cover 80% of medically necessary services, such as doctor visits and mental health therapy, after a $283 annual deductible. These medical and psychological costs are often reduced further by supplemental Medigap policies, leaving families to focus solely on the residential costs.
Q: What happens to my loved one’s mental health coverage if they stay past 100 days?
A: This is where many families find relief. While the coverage for the "room" (Part A) might end after 100 days, Medicare Part B remains a permanent fixture of the resident's care plan. Because emotional support is a vital part of health, Medicare treats therapy and psychiatric check-ins as essential "medically necessary" care. This means that even after a move, Part B continues to look after your loved one just as it did when they were living at home.
Q: How do we handle the gap in payment for therapy sessions?
A: Most families find that the financial burden is much lower than they feared. Once the 2026 Part B deductible of $283 is met, Medicare pays 80% of the cost. If your loved one has a Medigap (Supplemental) policy, that secondary insurance usually "wraps around" to pay the remaining 20%. In many cases, this results in a $0 out-of-pocket cost for regular psychotherapy sessions, allowing the focus to stay entirely on healing.
Q: Is transportation required for therapy?
A: No. At Pacific Coast Psychology, we bring the care to the bedside. This eliminates the physical stress of transport and ensures that mental health support is a seamless part of the resident's daily life.
