Medicare Doesn’t Cover the Long-Term Care You’re Worried About 

Every October, the kitchen table fills up with Medicare mail. Medicare Open Enrollment runs October 15 through December 7, 2026, and plenty of Connecticut families will spend hours comparing plans for next year. 

The catch? None of those plans pays for what most families lose sleep over: a parent who needs help bathing, dressing, or staying safe at home. That’s custodial care, and Medicare generally won’t cover it when it’s the only care someone needs. 

So does Medicare cover long-term care in Connecticut?

Generally, no. That’s where planning comes in. 

Where Medicare Stops Paying 

Medicare Part A covers skilled nursing facility care for a limited time, and only after a qualifying inpatient hospital stay of at least three days in a row. Time spent “under observation” doesn’t count, even overnight. 

For 2026, the math in each benefit period looks like this: 

• Days 1 through 20: $0 per day 

• Days 21 through 100: $217 per day 

• Day 101 and beyond: you pay everything 

A Medigap policy can cover that daily coinsurance, but not custodial care. Switching plans this fall won’t close the gap. 

What Long-Term Care Costs in Connecticut 

Connecticut ranks fifth in the nation for nursing home costs. A semi-private room carries a median price of $182,500 a year, about $15,208 a month, according to the CareScout 2025 Cost of Care Survey. 

When Medicare steps back, families pay one of three ways: 

• Savings, which drain fast at that rate. 

• Long-term care insurance. Connecticut Partnership policies let you keep assets equal to what the policy paid if you later need Medicaid (CGS § 17b-252). 

• Medicaid, known here as Title 19 or HUSKY C, which caps a single applicant at $1,600 in countable assets. 

The Five-Year Look-Back Is Already Running 

When someone applies for long-term care Medicaid, the Connecticut Department of Social Services (DSS) reviews every transfer from the prior 60 months. Gifts to children, below-market sales, and transfers into certain trusts can trigger a penalty period (CGS § 17b-261a). 

The penalty clock only starts once the applicant is otherwise eligible, which usually means already in care and already out of money. 

In 2027, retroactive Medicaid coverage for older adults also shrinks from three months to two, leaving less room for a last-minute application. Our September article for caregivers covers look-back planning in more depth. 

Why 2028 Belongs on Your Radar 

Under the federal budget law signed in July 2025, Medicaid won’t pay for nursing home or home-based long-term care starting in January 2028 if the applicant’s home equity tops $1 million. That cap isn’t indexed for inflation. 

This one lands squarely on Connecticut, one of about a dozen states using the higher federal limit (roughly $1.13 million in 2026), according to Justice in Aging. In 2028 that ceiling drops to $1 million and stays put while home values climb. 

A house bought in Glastonbury, Hebron, or Tolland decades ago may be worth more than anyone realizes. The limit doesn’t apply if a spouse, a child under 21, or a blind or disabled child lives there. Everyone else should know their number. 

Plan at the Kitchen Table, Not the Hospital Discharge Desk 

Attorney Patrick M. Prue served more than 20 years as a Connecticut probate judge. Conservatorship petitions land in that court when a parent can no longer make decisions and nobody has legal authority to act (CGS § 45a-644 et seq.). Many start with a hospital stay and no power of attorney on file. 

While you review plans this season, add these to the list: 

• Book a free plan review with CHOICES, Connecticut’s Medicare counseling program: 1-800-994-9422. 

• Confirm a power of attorney (CGS § 1-350 et seq.) and health care representative (CGS § 19a-575a) are signed and current. 

• List any gifts from the past five years. 

• Check how the house is titled and what it’s worth. 

• Ask an elder law attorney whether a Partnership policy or an irrevocable trust fits your family. 

October Is Also Residents’ Rights Month 

Consumer Voice, the national advocacy group behind the observance, chose “Join Us at the Table” as its 2026 theme. Connecticut protects nursing home residents with a statutory bill of rights (CGS § 19a-550). Planning early gives your family more say in where care happens and how it’s paid for. 

When Legal Matters, We’re Here For You 

Medicare choices have a December 7 deadline. Long-term care planning doesn’t, which is why it keeps getting pushed off. Talk with our elder law team while every option is still on the table. Schedule a consultation at any of our four offices in Willimantic, Brooklyn, Coventry, or Colchester. Call (860) 423-9231 or visit pruelawgroup.com. 

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Sources

1. Centers for Medicare & Medicaid Services, Medicare Open Enrollment (October 15 to December 7). medicare.gov  
2. Medicare.gov, Skilled nursing facility care. medicare.gov/coverage/skilled-nursing-facility-care 
3. Medicare.gov, Long-term care coverage and Nursing home care. medicare.gov/coverage/long-term-care 
4. Centers for Medicare & Medicaid Services, 2026 Medicare Parts A & B Premiums and Deductibles fact sheet. cms.gov 
5. CareScout, Cost of Care Survey 2025, Ranked Median Costs by State (released March 2026). carescout.com 
6. Connecticut Department of Social Services, HUSKY C eligibility. portal.ct.gov/dss 
7. Connecticut General Statutes § 17b-261a, transfer of assets and penalty periods. cga.ct.gov 
8. Connecticut General Statutes § 17b-252 et seq., Connecticut Partnership for Long-Term Care. cga.ct.gov 
9. One Big Beautiful Bill Act, Public Law 119-21, § 71108, amending 42 U.S.C. § 1396p(f) (home equity limit), signed July 4, 2025. 
10. Justice in Aging, H.R. 1 Imposes New Limit on Home Equity for Medicaid Long-Term Services and Supports Effective 2028 (April 9, 2026). justiceinaging.org 
11. Association of State and Territorial Health Officials, One Big Beautiful Bill Law Summary (retroactive coverage provisions). astho.org 
12. Connecticut General Statutes § 45a-644 et seq., conservators. cga.ct.gov 
13. Connecticut General Statutes § 1-350 et seq. (Uniform Power of Attorney Act) and § 19a-575a (health care representatives). cga.ct.gov 
14. Connecticut General Statutes § 19a-550, patients’ bill of rights. cga.ct.gov 
15. The National Consumer Voice for Quality Long-Term Care, 2026 Residents’ Rights Month. theconsumervoice.org 
16. Connecticut Department of Aging and Disability Services, CHOICES program. portal.ct.gov/ads 

The Prue Law Group has served eastern and central Connecticut since 1980, providing comprehensive business law, estate planning, probate, and elder law services. Our team’s deep local knowledge and specialized expertise help families protect what matters most. AI may have been used for the initial research and drafting of the article. This content is intended for general informational purposes only and should not be construed as legal advice. For guidance on your specific situation, please contact our office for a consultation.