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What Medicare Does and Does Not Pay For

Medicare covers short skilled nursing stays, home health and hospice. It does not pay for assisted living or custodial care, in any state.

HomeCosts & PayingWhat Medicare Does and Does Not Pay For
Short answer

Medicare does not pay for assisted living, memory care, or long-term custodial care anywhere in the country. It covers limited skilled nursing facility stays after a qualifying hospital admission, intermittent skilled home health, and hospice.

What Medicare covers

  • Skilled nursing facility care after a qualifying inpatient hospital stay, for a limited period, when skilled care is needed daily. This is rehabilitation, not long-term placement.
  • Home health that is intermittent and skilled — nursing visits, physical, occupational or speech therapy. Not a caregiver who stays with your parent.
  • Hospice — the hospice team, medications related to the terminal diagnosis, and equipment. Not room and board in a facility.
The observation status trap. A Medicare skilled nursing benefit requires a qualifying inpatient hospital admission. Time spent under “observation status” does not count, even if your parent slept two nights in a hospital bed. Ask the hospital directly whether your parent is admitted as an inpatient or under observation, and ask in writing.
What senior care costs. Texas's 2024 CareScout state medians: $5,250/month assisted living, $7,087/month private nursing home room. No memory-care median exists anywhere. Read the full explanation →

Questions families ask

What's the difference between Texas's Medicaid expansion and Medicaid for seniors?

Texas has not expanded Medicaid under the Affordable Care Act, but that decision has no bearing on long-term-care Medicaid for seniors, which is a completely separate, decades-old eligibility pathway for people who are 65 or older, or blind or disabled.

How does a Fort Worth family apply for the STAR+PLUS HCBS waiver?

Apply through Your Texas Benefits online, or call Texas 2-1-1 and ask for the aging and disability services option. A Texas HHSC caseworker will complete a nursing-facility level-of-care assessment as part of determining eligibility.

What are Texas's nursing facility Medicaid income and asset limits in 2026?

For 2026, the special income limit for Texas nursing facility Medicaid is $2,901/month, with a $2,000 asset limit for a single applicant. Income above the limit generally requires a Miller Trust (Qualified Income Trust) to still qualify.

What is Medicaid Estate Recovery, and does it affect a Fort Worth family's home?

Texas's Medicaid Estate Recovery Program (MERP) can seek reimbursement from a deceased Medicaid recipient's probate estate for long-term-care costs paid by the state, including nursing facility care and some STAR+PLUS HCBS services -- but only after death, and with protections for a surviving spouse or dependent children.

What does assisted living cost in the Fort Worth area?

The 2024 CareScout Cost of Care Survey puts Texas's statewide median assisted living cost at $5,250 a month. No primary source publishes a Fort Worth- or Tarrant County-specific figure separate from that state median, so local pricing likely runs close to or somewhat above it given the metro's growth.

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