A $200,000 nest egg feels like a comfortable cushion until the first nursing-home bill arrives, and the math behind what happens next surprises most families who thought they had planned ahead.<\/p>\n
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Consider a widow who has spent years feeling secure about her $200,000 nest egg. Then she needs nursing-home care, and the first bill comes: $10,798 for one month in a private room.<\/p>\n
That\u2019s the 2025 national median from the CareScout Cost of Care Survey<\/a>. It works out to $355 a day, or $129,575 a year. If savings alone covered the whole bill, $200,000 would last about 18.5 months. In practice, her income usually goes toward care too. Once she meets her state\u2019s financial and care requirements, Medicaid can become the payer.<\/p>\n Medicare Covers Only Short-Term Skilled Nursing Care<\/p>\n Medicare does pay for some nursing-home care, just not for long. Part A covers a skilled nursing facility only after a \u201cqualifying inpatient hospital stay<\/a>\u201d of at least three days in a row, and only while a doctor says she needs daily skilled care such as IV medications or physical therapy.<\/p>\n In 2026, Original Medicare charges $0 per day for the first 20 covered skilled-nursing days after the Part A deductible is satisfied. Days 21 through 100 carry $217 daily coinsurance, and after day 100 she pays the full cost. Hospital observation time generally doesn\u2019t count toward the required inpatient stay.<\/p>\n Our widow needs help bathing, dressing and eating. That\u2019s long-term custodial care, not the short-term skilled nursing care Medicare is designed to cover.<\/p>\n Her Real Burn Rate Stretches to About 22 Months<\/p>\n The 18-month figure assumes savings pay the entire bill. In practice, her income goes toward care too. Assume she receives the 2026 average retired-worker benefit of $2,071 a month. After the $202.90 standard Part B premium and a $70 personal-needs allowance, the 2026 state median, about $1,798.10 remains for the nursing home.<\/p>\n That leaves roughly $9,000 a month for her savings to fill. In most states, nursing-home Medicaid limits countable assets to about $2,000, so she spends down $198,000. At that pace, her nest egg lasts almost exactly 22 months. If she then qualifies for Medicaid, most of her monthly income continues going toward her care.<\/p>\n Where she lives can move the finish line a long way. California lets one person keep $130,000 in countable assets through June 2027, far above the typical $2,000. Home-equity rules are separate: most states use limits between $752,000 and $1.13 million in 2026, while California currently has no home-equity limit.<\/p>\n If She\u2019s Married, Her Husband Could Keep Up to $162,660<\/p>\n Couples face very different math. Under the spousal impoverishment rules<\/a>, the husband living at home (the \u201ccommunity spouse\u201d) keeps a Community Spouse Resource Allowance<\/a>. For 2026, the federal floor is $32,532 and the ceiling is $162,660.<\/p>\n Many states protect half of the couple\u2019s countable assets for the spouse living at home, within those limits. In a state using that calculation and a $2,000 limit for her, a couple with $200,000 could protect $100,000 for him and $2,000 for her, leaving $98,000 to spend down. Some states use more generous calculations, so identical couples can face very different numbers.<\/p>\n