For Connecticut residents navigating nursing home care options, understanding what Medicare and Medicaid cover in 2025 is essential. Here’s a concise breakdown of what’s available and how the system works.

Medicare Coverage for Skilled Nursing Facility (SNF) Care

Medicare Part A provides coverage for short-term skilled nursing facility (SNF) care, but only under specific conditions. To qualify, you must have a qualifying hospital stay of at least three consecutive inpatient days (not counting observation stays), and you must enter a Medicare-certified SNF within 30 days of discharge. A physician must also certify that you require daily skilled care, such as wound treatment, rehabilitation, or IV therapy.

The 2025 Medicare cost-sharing structure is as follows:

Days 1–20: Fully covered by Medicare ($0 per day).
Days 21–100: You pay $209.50 per day.
Days 101 and beyond: You pay all costs out of pocket.

Medicare does not pay for long-term custodial care, such as help with bathing, dressing, or eating, when that is the only type of care needed. This is a common misconception. Most nursing home stays for chronic conditions or aging-related decline fall under this category and are not covered by Medicare.

Supplementary Coverage Options

If you’re concerned about the out-of-pocket costs for SNF care under Medicare, you may consider a Medigap (Medicare Supplement) plan. These can help cover the coinsurance for days 21–100. Alternatively, Medicare Advantage plans may offer different cost-sharing arrangements, though coverage rules still apply. Medicaid (HUSKY Health) for Long-Term Care

For long-term care needs, Medicaid—called HUSKY Health in Connecticut—is the primary payer for eligible individuals. Medicaid will cover room, board, personal care, and medical services in a Medicaid-certified nursing home.

To qualify for Medicaid in 2025:

Single applicants must have assets below $1,600.
Married applicants (if only one spouse applies) may retain up to $1,600 in the applicant’s name. The non-applicant (community spouse) may retain up to $157,920 in assets under the Community Spouse Resource Allowance.
Income must be less than the cost of care.

Additionally, the applicant must be medically eligible, requiring a nursing home level of care as determined by the state’s clinical criteria.Final Thoughts

In summary, Medicare only covers short-term skilled nursing care—not long-term custodial stays. Medicaid can help with long-term nursing home costs for eligible Connecticut residents. Given the complexity of eligibility rules and personal financial circumstances, speaking with a Medicaid planning specialist or elder law attorney can ensure you or your loved one receives the appropriate coverage.

Disclaimer: The information provided in this article does not, and is not intended to, constitute legal advice and is for general informational purposes only.

Let Us Know How We Can Help!

Please fill in your contact information and a brief message about what you need help with. A consultation will need to be scheduled in order to provide legal guidance.