Two kinds of nursing home care
- Skilled nursing care is short-term care from nurses or therapists, usually rehab after a hospital stay for a stroke, a fracture or surgery. Medicare Part A covers it under strict rules.
- Custodial care is long-term help with bathing, dressing, eating and other daily activities. Medicare doesn't cover it when that is the only care you need.
What Medicare pays for skilled nursing
Under Original Medicare you need a qualifying inpatient hospital stay of at least three days, a doctor's order for daily skilled care, and a Medicare-certified facility. For each benefit period in 2026:
| Days in the facility | You pay |
|---|---|
| Days 1 to 20 | $0 |
| Days 21 to 100 | $217 per day |
| Day 101 and after | All costs |
Coverage stops sooner if you no longer need daily skilled care. Medigap Plans C, D, F, G, M and N pay the daily coinsurance; Plans K and L pay part of it. More on our skilled nursing page.
Paying for long-term nursing home care in Oregon
In Oregon, Medicaid long-term care is part of the Oregon Health Plan and is run by the Oregon Department of Human Services (ODHS) Aging and People with Disabilities program. Eligibility depends on income, resources and how much daily help you need.
- Medicaid can pay for care at home, in adult foster homes, assisted living, residential care, endorsed memory care communities and nursing facilities.
- PACE, a combined Medicare and Medicaid program for people 55 and older who need a nursing home level of care but can live safely at home, is available in some Oregon counties.
- Oregon's estate recovery program can make a claim for Medicaid long-term care costs after death, so ask ODHS how it applies before you plan.
For long-term care options, call ODHS Aging and People with Disabilities at 1-855-673-2372. To apply for Medicaid, go to benefits.oregon.gov or call ONE Customer Service at 1-800-699-9075. You can check any facility's license on the state's long-term care licensing search.
If Medicare coverage ends too soon
If the facility gives you a Notice of Medicare Non-Coverage and you disagree, ask for a fast appeal from Oregon's Medicare quality improvement organization, Acentra Health, at 1-888-305-6759, no later than noon the day before your coverage ends. See Medicare appeals in Oregon.
Related questions
Does Medicare cover skilled nursing care in Oregon?
The 100-day benefit, step by step.
Does Medicare cover assisted living in Oregon?
What Medicare and Medicaid pay.
Does Medicare cover memory care in Oregon?
Dementia care and who pays.
Does Medicare pay for in-home caregivers in Oregon?
Home health versus personal care.
Sources
- Medicare.gov — Nursing home care
- Medicare.gov — Skilled nursing facility care
- Oregon Department of Human Services — Long-term care
- Oregon Department of Human Services — Long-term care facility licensing search
- Medicare.gov — Compare Medigap plan benefits
More questions in this guide
- Does Medicare cover acupuncture in Oregon?
- Does Medicare cover ambulance service in Oregon?
- Does Medicare cover annual physicals in Oregon?
- Does Medicare cover assisted living in Oregon?
- Does Medicare cover bone density tests in Oregon?
- Does Medicare cover cataract surgery in Oregon?
- Does Medicare cover chiropractic care in Oregon?
- Does Medicare cover a colonoscopy in Oregon?
- Does Medicare cover CPAP machines in Oregon?
- Does Medicare cover dental care in Oregon?
- Does Medicare cover diabetic supplies in Oregon?
- Does Medicare cover flu shots in Oregon?
- Does Medicare cover hearing aids in Oregon?
- Does Medicare cover home health care in Oregon?
- Does Medicare pay for in-home caregivers in Oregon?
- Does Medicare cover mammograms in Oregon?
- Does Medicare cover me when I travel or spend winters outside Oregon?
- Does Medicare cover medical marijuana in Oregon?
- Does Medicare cover memory care in Oregon?
- Does Medicare cover mental health care in Oregon?
- Does Medicare cover naturopathic doctors in Oregon?
- Does Medicare cover oxygen therapy in Oregon?
- Does Medicare cover physical therapy in Oregon?
- Does Medicare cover prostate cancer screening in Oregon?
- Does Medicare cover psilocybin therapy in Oregon?
- Does Medicare cover skilled nursing care in Oregon?
- Does Medicare cover the shingles vaccine in Oregon?
- Does Medicare cover transportation to medical appointments in Oregon?
- Does Medicare cover vision care in Oregon?
- Does Medicare cover wheelchairs in Oregon?
Part of the guide: Learn Medicare — the Oregon starter guide · All questions
Frequently asked questions
What if I was in the hospital under observation?
Observation is outpatient care, so those days don't count toward the three-day inpatient stay Original Medicare requires for skilled nursing coverage, even if you stayed overnight. Ask the hospital whether you are an inpatient or an outpatient.
Does Medicare Advantage follow the same rules?
Medicare Advantage plans must cover skilled nursing care, but they can waive the three-day stay, use network facilities, require prior authorization and set their own cost sharing. Check your plan's Evidence of Coverage.
Does Medigap pay for a long-term nursing home stay?
No. Some Medigap plans pay all or part of the skilled nursing coinsurance for days 21 to 100, but no Medigap plan pays for custodial care or for days after Medicare's 100-day limit.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
