Winston-Salem Senior AdvisorWhen does Medicare pay for a nursing home?
Only for short-term skilled nursing or rehab after an inpatient hospital stay of at least three days, up to 100 days per benefit period, with no cost for days 1 to 20 and $217 a day for days 21 to 100 in 2026.
Observation days in the hospital do not count toward the three days. Medicare never pays for long-term custodial care.
How does a parent qualify for Medicaid in a nursing home?
By needing nursing home care and having countable resources of $2,000 or less; the resident then pays most of their income toward care each month, keeping a $70 allowance, and Medicaid pays the rest.
Apply at the county department of social services. A spouse at home is protected by federal spousal impoverishment rules.
What is the Medicaid look-back?
Medicaid reviews gifts and transfers made in the 60 months before an application, and transfers for less than fair value create a penalty period during which Medicaid will not pay for nursing home care.
Talk with an elder law attorney before moving assets. The VA has its own three-year look-back for pension.
What is CAP/DA?
The Community Alternatives Program for Disabled Adults is NC Medicaid's waiver that pays for aide hours, adult day health, respite and other services at home for adults who meet nursing facility level of care.
Counties often have waiting lists for CAP/DA slots, so apply early.
How much can VA Aid and Attendance pay?
For December 2025 through November 2026, the maximum is $2,424 a month for a veteran with no dependents, $2,874 with one dependent and $1,558 for a surviving spouse, minus countable income after care costs.
| Claimant | Maximum annual pension | About per month |
|---|---|---|
| Veteran with no dependents, Aid and Attendance | $29,093 | $2,424 |
| Veteran with one dependent, Aid and Attendance | $34,488 | $2,874 |
| Two veterans married to each other, both A&A | $46,143 | $3,845 |
| Surviving spouse, no dependents, Aid and Attendance | $18,697 | $1,558 |
| Veteran with no dependents, Housebound | $21,313 | $1,776 |
VA Maximum Annual Pension Rates in effect December 1, 2025 through November 30, 2026.
Is PACE available in Winston-Salem?
Not yet; PACE of the Triad West in Winston-Salem is listed by the North Carolina PACE Association as coming soon for Forsyth, Stokes and Surry, while Carolina SeniorCare in Lexington serves Davidson and Davie counties now.
Yadkin County has no PACE program.
Does Medicare Advantage change what is covered in a nursing home?
Medicare Advantage plans must cover at least what Original Medicare covers, but they often waive the three-day hospital rule, set their own copays for skilled nursing days and limit stays to network homes that the plan approves a week or two at a time.
Before a hospital discharge, ask the plan which skilled nursing facilities in the five counties are in network and how it decides when coverage ends. The same plan does not pay for long-term custodial care any more than Original Medicare does.
