Explaining Medicare and Medicaid on a Care Provider Website

Updated 2026-10-16 · 7 minute read

Why the payment page matters more than you think

Ask any admissions director what families ask first and the answer is almost always money. Will Medicare pay? For how long? What happens after that? A clear payment page answers the first round of those questions before the phone rings, so your admissions team can spend the call on the person, not on reciting the basics.

It also protects you. A family that read "Medicare covers 100 days" on your site and then gets a bill on day 21 does not blame Medicare. They blame you. Every sentence on this page should be something you would be comfortable having read back to you by a surveyor, an ombudsman or a family's attorney.

The rule of thumb: explain the general program rules accurately, link to the official source, show the current year's numbers, and send people to a named person for their specific situation. Do not try to determine anyone's eligibility on a web page.

Medicare and skilled nursing: the rules to get exactly right

Medicare Part A covers short-term skilled nursing facility (SNF) care, not long-term living in a nursing home. According to Medicare.gov's SNF coverage page, the basic conditions are a qualifying inpatient hospital stay of at least 3 days in a row, a doctor's decision that the person needs daily skilled care, and care in a Medicare-certified SNF for a condition that was treated during the hospital stay (or a new condition that started while getting SNF care for it).

Two details trip families up, and your page should spell both out. First, the day of admission counts toward the 3 days but the day of discharge does not. Second, time spent under observation or in the emergency room before being admitted does not count, even overnight. Medicare.gov also notes that a person who was changed from inpatient to outpatient observation may be able to appeal.

Here is what a person pays in 2026, per Medicare.gov and the CMS fact sheet on 2026 Part A and B amounts:

Days 1 through 20: $0 per day. The Part A deductible ($1,736 in 2026) applies once per benefit period, and most people have already met it during the hospital stay.
Days 21 through 100: $217 per day in 2026, up from $209.50 in 2025.
Day 101 and after: the person pays all costs.
Medicare Advantage plans may charge copayments during the first 20 days and may waive the 3-day hospital requirement. Families should check with their plan.

Say "up to 100 days" every time, never "100 days." Coverage continues only while the person still needs and gets daily skilled care, so many stays end well before day 100. A benefit period ends after 60 days in a row without inpatient hospital or SNF care, per the CMS Medicare General Information manual, chapter 3, which is why someone readmitted a few weeks later may not get a fresh 100 days.

Put the year next to every dollar figure ("$217 per day in 2026") and put a reminder on your calendar. CMS announced the 2026 amounts on November 14, 2025, and publishes new amounts every year. A page that still shows last year's coinsurance in February tells families you are not paying attention.

What Medicare does not pay for, said plainly

This is the sentence most provider websites leave out, and it is the one families most need. Medicare.gov's long-term care page says it directly: Medicare doesn't pay for long-term care, which it calls custodial care. That includes help with daily activities in a nursing home, in the community, or in an assisted living facility.

If you run assisted living or memory care, say on your site that Medicare does not cover room, board or personal care in your community, then explain what does help: private pay, long-term care insurance, and in some states a Medicaid waiver. If you run a nursing home, separate your short-term rehab page from your long-term care page so a family reading about Medicare coverage does not assume it applies to a permanent move.

Medicare home health and hospice benefits

For home health, Medicare.gov says a person must be homebound, must need part-time or intermittent skilled services, must have a face-to-face visit with a doctor or allowed provider who orders the care, and must get the care from a Medicare-certified agency. The person pays nothing for covered home health services. Medical equipment is different: after the Part B deductible ($283 in 2026), the person pays 20 percent of the Medicare-approved amount.

Your home health page should also list what Medicare does not cover at home: 24-hour care, meal delivery, homemaker services like shopping and cleaning that are not part of the care plan, and personal care when that is the only care someone needs. Families often call a home health agency when what they actually need is private-duty help. Saying so clearly saves everyone time.

For hospice, Medicare.gov's hospice page lists the core requirements: the person has Part A, the hospice doctor (and the regular doctor, if there is one) certifies a terminal illness with a life expectancy of 6 months or less, the person accepts comfort care instead of curative treatment for that illness, and the person signs an election statement. Benefits run in two 90-day periods followed by an unlimited number of 60-day periods.

Hospice care from a Medicare-approved provider: $0.
Outpatient drugs for pain and symptom control: up to $5 per prescription.
Inpatient respite care: 5 percent of the Medicare-approved amount.
Room and board at home, in a nursing home or in a hospice residence: not covered (short-term respite stays the team arranges are the exception).

Hospice sites often say "hospice is free." It is better to say "Medicare covers hospice care related to the terminal illness at no cost to you, with small copays for some drugs and respite care. Medicare does not pay for room and board." A family whose mother lives in a nursing home needs to know that her monthly room charge does not stop when hospice starts.

Medicaid: explain the shape of it, not the eligibility math

Medicaid rules vary by state, so your page should explain the general shape and send families to the right place for details. A few federal points are safe to state. According to Medicaid.gov's nursing facilities page, state Medicaid programs must cover nursing facility services for people age 21 or older who need them, each state sets its own level of care criteria, and states may not put nursing facility care on a waiting list.

Home and community-based services are different. Under Section 1915(c) waivers, states can pay for services like personal care, homemaker help, case management and respite for people who would otherwise need institutional care, and states choose the maximum number of people a waiver will serve. Federal rules at 42 CFR 441.310 exclude room and board from waiver payments, with narrow exceptions such as respite in a facility. So if your assisted living community accepts a waiver, say what the waiver pays for and that residents still pay room and board.

Two more federal rules belong on the page because they shape how families plan. Medicaid.gov's eligibility policy page explains that people who transferred assets for less than fair market value in the five years before applying can be denied long-term care coverage for a period, and that states must recover the cost of nursing facility and home and community-based services from certain enrollees' estates. Mention both, briefly, and then stop. Do not explain how to qualify faster or how to protect assets. That is legal and financial advice, and it belongs with an elder law attorney or the state Medicaid agency.

Say which Medicaid programs you participate in, by their official state names.
Link to your state Medicaid agency's application page.
Say whether you accept residents who will spend down to Medicaid after a private-pay period, and on what terms, only if your policy is settled and your counsel has approved the wording.
Give a named contact (business office manager or admissions director) for Medicaid questions.

VA benefits for veterans and spouses

Veterans and their families will ask. VA's long-term care page lists three nursing home options: VA Community Living Centers, community nursing homes that contract with VA, and State Veterans Homes. A veteran must be enrolled in VA health care, VA must decide the service is needed, and the service must be available nearby. If you hold a VA community nursing home contract, say so plainly on your site, because that is real information a veteran's family can act on.

Be careful with assisted living. VA's page says VA does not run, staff or pay for assisted living facilities, though it may cover some extra services. Separately, the VA Aid and Attendance benefit adds a monthly payment to a VA pension for veterans or survivors who need help with daily activities or live in a nursing home. It requires being eligible for a VA pension first, uses VA Form 21-2680, and nursing home residents also submit VA Form 21-0779. You can mention the benefit and link to it. You should not tell a family they will qualify.

What not to promise on your website

Most payment-page problems come from a few phrases that sound helpful and are not quite true. Read your current site for these:

"Medicare covers 100 days of rehab." Say "up to 100 days per benefit period, if you continue to need daily skilled care."
"We accept Medicare and Medicaid" on an assisted living or memory care page where neither pays for the stay itself.
"Hospice is free" without the room and board caveat.
"We'll help you qualify for Medicaid" or "protect your assets." Your staff can help with paperwork. Planning is for attorneys.
"Veterans pay nothing" or "VA will cover your stay."
Dollar figures with no year, or last year's figures.
"Medicare-approved" or "Medicare-certified" on a service line that is not certified.

Before you publish, have your business office manager, administrator and compliance officer read the page. Rules change, plans differ, and state programs have their own names and limits. This guide describes what the federal sources say. It is not legal advice, and your organization should confirm the wording with its compliance officer or counsel.

Checklist

Separate pages or sections for short-term rehab (Medicare) and long-term care (private pay, Medicaid, VA).
Every dollar amount labeled with its year; calendar reminder to update when CMS releases new amounts.
A plain sentence that Medicare does not pay for long-term custodial care or assisted living.
Hospice page states that Medicare does not cover room and board.
Medicaid programs named as the state names them, with a link to the state application.
VA contract status stated only if you hold one; Aid and Attendance linked, not promised.
A named person and direct phone number for payment questions.
Links to Medicare.gov, Medicaid.gov and VA.gov so families can check the rules themselves.
Compliance officer sign-off before launch and at every annual update.

Questions

Should we list the SNF daily coinsurance amount on our website?

Yes, if you keep it current. The 2026 amount for days 21 through 100 is $217 per day, per CMS. Label it with the year and link to Medicare.gov so families can confirm it. If you know you will not update it each year, link to Medicare.gov instead of quoting a number.

Can our website say Medicaid pays for assisted living?

Only in the specific way your state's program works. Many states use Medicaid waivers to pay for services in assisted living, but federal waiver rules exclude room and board, so residents still pay that part. Name the program, say what it covers, and send families to your business office for details.

Does the 3-day hospital stay rule apply to everyone?

It is the standard rule under Original Medicare. Medicare.gov notes that some Medicare Advantage plans, and doctors in some accountable care organizations with a waiver, may not require it. Tell families to ask their plan or hospital, and do not assume either way on their behalf.

Is it risky to explain the Medicaid five-year look-back on our site?

Stating that the rule exists, with a link to Medicaid.gov, is fine and helpful. Explaining how to arrange assets around it is not your role. Point families to the state Medicaid agency or an elder law attorney, and have your counsel review the wording.

Sources

This guide is general information, not legal advice. Confirm regulatory and legal questions with your compliance officer or counsel.

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How to explain Medicare, Medicaid and VA benefits on your website