Does Medicare Cover Nursing Home Care in Minnesota? Medicare vs Medicaid in 2026

Nursing home care in Minnesota is a confusing topic, especially because Medicare and Medicaid sound so similar.

If a loved one may need long-term care, one of the first questions families ask is, “How are we going to pay for this?”

Understanding the difference between Medicare and Medicaid can help you avoid costly mistakes and give your family more options for the future.

The short answer:

• Medicare covers short-term skilled care.
• Medicaid (called Medical Assistance, or MA, in Minnesota) covers long-term custodial care.

Understanding that distinction, and medicaid planning around it before a crisis hits, could save your family hundreds of thousands of dollars.

Why This Confusion Is So Common

Medicare and Medicaid sound similar, and both serve older adults, but they work very differently when it comes to long-term care.

Many families assume that because a parent has been on Medicare for years, it will eventually cover nursing home costs. 

It will not. 

Beyond a short window following a qualifying hospital stay, Medicare stops paying for long-term care entirely.

This is one of the most misunderstood facts in elder law planning, and getting clear on it early gives your family time to protect what you’ve worked so hard to build. 

For context on what that care actually costs in Minnesota, see our full breakdown of current nursing home costs in Minnesota.

What Medicare Actually Covers for Long-Term Care

Medicare is a federal health insurance program that most people over 65 are enrolled in. But when it comes to nursing home or custodial care, Medicare has strict limits. 

One of the biggest surprises for families is learning that Medicare was never intended to pay for ongoing long-term care.

What Medicare will cover:

• Up to 100 days in a skilled nursing facility (SNF) per benefit period, after a qualifying hospital stay of at least 3 days
• Days 1 through 20 are covered in full
• Days 21 through 100 require a daily coinsurance of $217 in 2026 (up from $209.50 in 2025), per the CMS 2026 Medicare Parts A & B premiums and deductibles fact sheet
• After day 100, Medicare pays nothing

What Medicare will NOT cover:

• Ongoing custodial care, such as help with bathing, dressing, and eating
• Long-term nursing home stays
• Assisted living facility costs
• Most in-home care that isn’t medically necessary

The key distinction is skilled versus custodial care. 

Once a person no longer needs skilled nursing or therapy services and simply needs help with daily living tasks, Medicare steps aside. 

At that point, families either pay out of pocket, use long-term care insurance if they have it, or turn to Medicaid.

What this Means for Your Family: 

Many people assume Medicare will cover an extended nursing home stay, only to discover that coverage ends much sooner than expected, often within weeks, not years. Understanding this now gives you time to prepare before you’re in the middle of a crisis.

What Medicaid Covers for Long-Term Care in Minnesota

Medicaid, known in Minnesota as Medical Assistance (MA), is a state and federal program that may cover long-term nursing home care and home-based care services for those who qualify financially and medically.

A semi-private nursing home room in Minnesota runs a median of roughly $127,750 a year, and a private room roughly $166,440 a year, per the CareScout (Genworth) 2025 Cost of Care Survey, see our detailed cost breakdown for the full numbers and regional variation. This is not a small benefit: for qualifying individuals, Medicaid can cover the full ongoing cost of care.

Minnesota Medicaid long-term care programs include:

• Nursing Home Medicaid (MA-LTC) — covers care in a Medicaid-certified facility for eligible individuals
• Elderly Waiver (EW) — pays for care in your home, an assisted living facility, or an adult foster home, allowing some seniors to avoid nursing home placement altogether
• HCBS Waivers — Home and Community-Based Services that help eligible individuals remain in the community

Financial Eligibility in Minnesota

To qualify for Medicaid long-term care in Minnesota, a single individual may have no more than $3,000 in countable assets. For a married couple where only one spouse is applying, the community spouse (the one staying at home) may currently keep up to $162,660 in assets, plus the home.

This protection for the at-home spouse exists under the spousal impoverishment rules, governed by Minnesota Statutes, Section 256B.059. 

You can find official program details and the application process on the Minnesota DHS Long-Term Services and Supports page.

These numbers often surprise families. 

The good news is that legal planning strategies may help preserve assets while still qualifying for benefits, every family’s situation is different, which is why personalized Medicaid planning matters so much.

What this Means for Your Family: 

Medicaid can be an incredible resource, but qualifying involves much more than simply filling out an application. Planning ahead often provides the greatest flexibility, care options, and asset protection.

The 5-Year Lookback Rule: Why Timing Matters

One of the most critical rules in Minnesota Medicaid planning is the 5-year lookback period.

Under Minnesota Statutes, Section 256B.0595, Medicaid reviews all asset transfers made within the five years before an application is filed. 

If you gave money to a child or charity, transferred property, or sold assets for less than fair market value during that window, Medicaid may impose a penalty period during which you’d be ineligible for benefits. 

The penalty is calculated by dividing the value of the transferred assets by the average monthly cost of nursing home care in Minnesota.

Gifting assets to children in a panic when a crisis hits is one of the most common, and costly, mistakes families make. (If you’re weighing whether to gift a home or other property to your kids, read our take on that decision before you do.)

The five-year lookback is one of the biggest reasons we encourage families to begin planning sooner rather than later. 

The earlier you plan, the more flexibility you’re likely to have. 

In most situations, legal strategies may still help protect assets even within the lookback period, but they require an experienced Medicaid attorney to structure correctly. 

A properly designed Medicaid Asset Protection Trust is one such tool, though Minnesota’s rules on when these trusts are effective are stricter than in many other states.

What this Means for Your Family: 

Even if you or your loved one has already received a diagnosis, don’t assume it’s too late. There may still be planning opportunities depending on your circumstances, see our guide on protecting assets if a spouse enters a nursing home for a closer look at crisis-stage options.

How Safe Harbor Estate Law Can Help

Medicaid planning is one of the most complex areas of estate planning (less than 5% of attorney firms offer these services), and even small mistakes can have significant financial consequences. 

For more than 13 years, our team at Safe Harbor Estate Law, has helped families navigate these rules to protect their hard-earned assets before a long-term care crisis occurs. 

Attorney Michael Teeter helped brief a landmark 2021 Minnesota Court of Appeals case that affirmed Minnesotans have the same rights as residents of the other 49 states to use irrevocable Medicaid Asset Protection Trusts (MAPTs) as part of their long-term care planning.

Following that decision, the Minnesota Department of Human Services (DHS) issued guidance that significantly limits when these trusts are effective for Medical Assistance eligibility, making them an appropriate strategy for fewer families than in many other states. 

Because of these unique Minnesota rules, experience matters, our team has extensive experience designing MAPTs and navigating the DHS guidance, and we help families determine whether a MAPT, an irrevocable trust structured for creditor and Medicaid protection, or another Medicaid planning strategy will better accomplish their goals.

Founded by attorney Margaret Barrett, Safe Harbor Estate Law is built on a commitment to helping families preserve what they’ve worked a lifetime to build. 

Today, our team of elder law and estate planning attorneys collaborates on customized Medical Assistance and asset protection strategies for clients throughout Minnesota and Wisconsin.

Frequently Asked Questions

Does Medicare pay for nursing home care in Minnesota? 

Medicare may cover short-term skilled nursing care, up to 100 days per benefit period, following a qualifying hospital stay. It does not cover long-term custodial care, which is what most nursing home residents need. See the Medicare section above for a full breakdown.

How do I qualify for Medicaid long-term care in Minnesota?

To qualify for Minnesota Medical Assistance for long-term care, you must meet both medical and financial eligibility requirements. For a single applicant, countable assets generally may not exceed $3,000, and income limits also apply. See the financial eligibility section above, or speak with a Medicaid planning attorney about your specific situation.

What is the 5-year lookback rule in Minnesota?

Minnesota’s Medicaid program reviews all asset transfers made within the five years before an application is filed. If assets were given away or sold for less than fair market value during that period, a penalty period of ineligibility may apply. See the lookback rule section above for details on how this affects your planning.

Can my spouse keep the house if I go on Medicaid in Minnesota?

 In most cases, yes. A home is generally an exempt asset for a community spouse (the spouse who remains at home) under Minnesota’s spousal impoverishment rules. However, Minnesota does have estate recovery laws that allow the state to seek reimbursement from the estate after both spouses have passed. An attorney can help your family plan around this to some extent.

What is the difference between skilled care and custodial care? 

Skilled care involves medical services provided by licensed professionals, such as physical therapy, wound care, or IV medications, and is what Medicare will cover on a short-term basis. Custodial care refers to help with everyday tasks like bathing, dressing, and eating, which doesn’t require a medical license to provide. Most long-term nursing home residents need custodial care, and that’s the gap Medicare doesn’t fill, but Medicaid may.

What happens after Medicare’s 100 days of nursing home coverage run out?

Once Medicare coverage ends, families face three options: pay out of pocket (at a median of roughly $10,600–$13,900 a month in Minnesota, per the CareScout 2025 Cost of Care Survey), rely on long-term care insurance if they have it, or apply for Medicaid. For families who haven’t planned ahead, this transition can arrive quickly and unexpectedly. Understanding this cliff before it happens is exactly why early Medicaid planning matters.

What is estate recovery, and could it affect my family? 

Minnesota’s estate recovery program allows the state to seek reimbursement for Medicaid benefits paid on a recipient’s behalf after they pass away. This can include making a claim against the deceased person’s estate, which may involve their home. While a community spouse’s home is generally protected during their lifetime, estate recovery can become a factor after both spouses have passed. An elder law attorney can help your family structure a plan that minimizes this risk.

The Bottom Line for Minnesota Families

Planning for long-term care isn’t just about protecting assets; it’s about protecting your family’s peace of mind. 

Whether you’re planning years in advance or facing an immediate care need, understanding the difference between Medicare and Medicaid can help you make confident decisions about the future.

The earlier you begin planning, the more options you’ll typically have. 

And if you’re not sure where to start, reach out and we will help you understand what may be possible for your family.

This blog post is for informational purposes only and does not constitute legal advice. Laws and program limits change regularly. Please consult a qualified Minnesota estate planning attorney for guidance specific to your situation.