Understanding the Continuum of Care

The Help Project

3 in 4 people over 65 will need long-term care services. Most families assume Medicare will cover it. Use the filter below to see what it actually pays for — and what it doesn't.

Facility-Based Care

Skilled Nursing Facility

Medicare: limited$8,000–$15,000/mo

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Round-the-clock comprehensive nursing care for chronic illness or short-term rehabilitation. A licensed nurse is required on premises 24 hours a day.

Who this is for: Post-surgery recovery, complex medical needs, or anyone requiring 24-hour skilled nursing care.

Medicare coverage

Medicare covers up to 100 days following a qualifying 3-day hospital stay. Days 1–20: fully covered. Days 21–100: ~$200/day copay. After day 100: Medicare pays nothing. Ongoing custodial care is never covered.

Subacute Care Facility

Medicare: limited$8,000–$14,000/mo

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Often part of a skilled nursing facility, designed for people with complex medical conditions including tracheostomy care and patients on ventilators.

Who this is for: High-complexity medical needs requiring a step-down level between the hospital and home.

Medicare coverage

Same Medicare benefit as Skilled Nursing — up to 100 days following a qualifying hospital stay, with the same coverage limits and daily copays.

Institutes for Mental Health

Medicare: limitedVaries by program

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Special treatment programs within skilled nursing centers providing extended treatment for adults with chronic mental health issues and pathways to re-integrate into the community.

Who this is for: Adults managing chronic mental health conditions alongside aging care needs.

Medicare coverage

Medicare covers some inpatient psychiatric services, but coverage is limited and program-specific. Psychiatric hospital stays are capped at 190 lifetime days under Medicare Part A.

Continuing Care Retirement Communities (CCRCs)

Medicare: limited$3,000–$10,000+/mo + entrance fee

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Three levels of care on one campus — independent living, assisted living, and skilled nursing. Require a significant entrance fee ($100K–$1M+) plus monthly payments covering services for a resident's lifetime.

Who this is for: People planning ahead who want to remain in one community without relocating as their needs change over time.

Medicare coverage

Medicare only covers the skilled nursing component, and only when all standard SNF requirements are met. Independent living and assisted living portions receive no Medicare coverage.

Assisted Living

Not covered by Medicare$3,500–$7,000/mo

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Licensed as Residential Care Facilities for the Elderly (RCFE). Provides meals, personal assistance with daily activities, and help with medications. Most have private apartments with tiered pricing based on care needs.

Who this is for: Unable to live alone safely, but does not require 24-hour skilled nursing care.

Medicare coverage

Medicare does not cover assisted living. Medicaid does fund assisted living in some states through HCBS waiver programs — but eligibility is income and asset based, waitlists are long, and most facilities don't accept Medicaid. The majority of families pay privately.

Memory Care

Not covered by Medicare$5,000–$9,000/mo

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Specialized secured care for people with Alzheimer's, dementia, and other cognitive conditions. Found in board and care homes, assisted living communities, and some skilled nursing facilities.

Who this is for: Moderate to advanced dementia where safety, wandering prevention, and specialized engagement are priorities.

Medicare coverage

Medicare does not cover memory care. Most families pay privately. Medicaid waiver programs exist in some states but waitlists stretch years. This is one of the most significant unplanned costs in eldercare.

Facility & Community-Based Care

Hospice

Medicare coversCovered by Medicare

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End-of-life care and family support for the terminally ill, provided at home or in a facility. Focuses on comfort, pain management, and quality of life rather than curative treatment.

Who this is for: A terminal prognosis of 6 months or less if the illness runs its expected course.

Medicare coverage

Medicare Part A covers hospice fully when a physician certifies a terminal prognosis. Includes nursing visits, comfort medications, aide services, social work, and grief counseling for the family — at no cost to the patient.

Home & Community-Based Care

Home Health Care

Medicare coversCovered when eligible

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Short-term skilled care in the home following a hospital or facility discharge, when skilled nursing or therapy interventions are medically necessary.

Who this is for: Post-hospital recovery requiring skilled nursing, physical therapy, or occupational therapy at home.

Medicare coverage

Medicare covers home health when you are homebound, need skilled care, and have a physician's care plan. This is not for ongoing personal care — only skilled medical services qualify. Coverage ends when the skilled need ends.

Board and Care

Not covered by Medicare$2,500–$5,000/mo

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Small 4–6 bed homes in residential neighborhoods providing personal assistance, meals, and medication help. Licensed as Residential Care Facilities for the Elderly. Generally shared rooms.

Who this is for: Needs personal care and cannot live alone safely, but prefers a smaller home-like setting over a large facility.

Medicare coverage

Medicare does not cover board and care. Medicaid covers room and board in some board and care homes through SSI supplements and HCBS waivers in some states — but availability is limited and often doesn't cover the full cost. Most families pay privately.

Home Care

Not covered by Medicare$25–$40/hr

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Non-medical home support for personal assistance — help with bathing, dressing, meals, and daily routines. Can be privately funded or covered through Medicaid's In-Home Support Services (IHSS) program.

Who this is for: Needs help with daily activities but can safely remain at home with support in place.

Medicare coverage

Medicare does not cover personal (custodial) home care. Medicaid does cover home care and HCBS for those who qualify financially — but hours are typically capped, waitlists exist in many states, and coverage rarely equals what a family needs. At 40+ hours per week of private-pay care, costs can rival assisted living quickly.

Adult Day Health Care

Not covered by Medicare$75–$150/day

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Community-based programs providing care, companionship, and basic health-related services for older adults who benefit from social engagement and daytime supervision.

Who this is for: Needs daytime structure and care while family caregivers work. Highly effective for early-to-mid stage dementia.

Medicare coverage

Medicare does not cover adult day health care. Medicaid does cover adult day programs in most states — but eligibility requires meeting income and asset limits, coverage varies by state, and hours are often limited. For families who qualify it can reduce costs meaningfully. For those who don't, it's private pay.

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