In short
Custodial care is non-medical help with everyday activities such as bathing, dressing, eating and using the bathroom. It can be given at home, in assisted living or in a nursing home. Original Medicare does not pay for custodial care when it is the only care someone needs. Families usually pay privately, through Medicaid, or with long-term care insurance.
Custodial care vs skilled care
^ Custodial and skilled care compared
| Custodial care | Skilled care | |
|---|---|---|
| --- | --- | --- |
| What it is | Help with daily activities and supervision | Nursing or therapy that needs licensed staff |
| Examples | Bathing, dressing, eating, toileting, moving from bed to chair | Wound care, injections, physical therapy |
| Given by | Aides, family, assisted living or nursing home staff | Nurses and therapists |
| Medicare | Not covered when it's the only care needed | Covered short term when the rules are met |
Why it matters
Medicare says it doesn't cover custodial care if that is the only care you need, whether at home, in assisted living or in a nursing home. That is why a long nursing home stay is usually not paid by Medicare, even though a short rehab stay after the hospital may be.
Who pays for custodial care
- Your parent's own money, the most common source
- Medicaid, for people who qualify, in nursing homes and through many state programs at home
- Long-term care insurance, if your parent has a policy; check what triggers benefits
- Veterans benefits, for some veterans and surviving spouses
How much custodial care is needed
Care teams measure it with activities of daily living. Our ADL guide explains the six tasks they check.
Questions families ask
Is assisted living custodial care?
Most of the care in assisted living is custodial: help with daily activities and supervision. Medicare doesn't pay for it.
Does Medicaid pay for custodial care?
Medicaid is the main public payer for long-term custodial care for people who meet their state's rules, in nursing homes and often at home.
Is custodial care the same as long-term care?
They overlap. Medicare describes long-term care as non-medical help with daily activities, which is custodial care.
Can custodial care be provided at home?
Yes. Home care aides, family members and companions all provide custodial care at home.