Long-term care services can be expensive, and many people are surprised to learn that government health programs typically cover only limited types of care and only under specific circumstances.¹ Knowing what these programs do and do not provide can help you better assess potential gaps and plan accordingly.

The U.S. government offers several programs that may help pay for certain long-term care-related expenses. However, eligibility requirements, coverage limits and state-specific rules mean these programs may not fully address long-term care needs for many individuals.

Understanding government benefit programs

Medicare, Medicaid and Veterans Affairs (VA) benefits are often part of conversations about paying for long-term care. While each program can play a role in covering certain medical or supportive services, they differ significantly in how they operate and the type of care they provide.

Understanding these differences can help set realistic expectations and support more effective long-term care planning.

Government programs at a glance

Medicare

Medicare is the federal health insurance program for individuals age 65 and older and for certain younger individuals with qualifying disabilities.² It generally covers hospital care, physician services, preventive care and prescription drugs but does not cover ongoing custodial care such as assistance with activities of daily living.

Under limited circumstances, Medicare may cover short-term skilled nursing care or skilled home health services when medically necessary, such as following a qualifying hospital stay. These services are intended for rehabilitation, not long-term care.²

Medicaid

Medicaid is a joint federal and state program that provides health coverage to individuals with limited income and assets.³ Eligibility rules and covered services vary by state.

Medicaid is the primary source of public funding for long-term care services in the United States and may help pay for nursing home care and certain home- and community-based services for individuals who meet eligibility requirements.⁴

Veterans Affairs benefits

The U.S. Department of Veterans Affairs (VA) provides health care and long-term care services to eligible veterans through a priority-based enrollment system. Access to long-term care services depends on factors such as service-connected disability status, income, medical need and availability of resources.⁵

Putting it all together

Government programs can help pay for certain health care and long-term care-related expenses, but coverage is often limited and subject to strict eligibility requirements. As a result, relying solely on government benefits may leave gaps in a long-term care strategy.

Understanding how Medicare, Medicaid, and VA benefits work can help you evaluate your options and determine whether additional planning approaches may be appropriate based on your goals and circumstances.