Medicare is a federal insurance program paid out of Social Security deductions. All persons 65 or older who have made Social Security contributions are entitled to the benefits, as well as persons under 65 with disabilities who have been eligible for Social Security disability benefits for at least two years, and persons of any age with end-stage renal disease.

Medicare does not pay for all medical expenses, and usually must be supplemented with private insurance ("medigap") or consumers can enroll in an HMO plan that contracts with Medicare. After 3 days of prior hospitalization, Medicare will pay up to 100% for the first 20 days of skilled nursing care. For the 21- 100 days, the patient will pay a co-payment. The premiums and copayments are increased every year. There will be no Medicare coverage for nursing home care beyond 100 days in any single benefit period.

It should be noted that Medicare only pays for “skilled nursing care,” does not pay for “custodial care” and the average stay in a nursing home under Medicare is usually less than 24 days. Thus, few can look to Medicare to pay for any substantial nursing home costs.

Unfortunately, no, Medicare does not pay for long term care in a nursing home.  Only your own money or if you and she can qualify will Medicaid  pay for your wife's nursing home care.  Your state is an income cap state, you if your income is too high, regardless of the assets you have, you still may not qualify for Medicaid.  Contact and elderlaw attorney in your State for more advice on Medicaid planning.

Without understanding your plans or financial situation completely, I’ll explain the rules and give guidance of where to turn to for specific answers on your situation.  Medicare Part A only covers skilled care given in a certified nursing facility for individuals who meet certain conditions.  Medicare doesn't cover all services. In most cases it doesn't cover long-term care stays in a nursing home.  The services that Medicare doesn't cover, you'll have to pay out of pocket for them, unless you have other insurance or a Medicare health plan that covers those services.  You may still have to pay your deductible, coinsurance, and co-payments.  To sum it up… you may still have out-of-pocket expenses each month.

Remember that Medicare is based on 3 main factors:

1) Federal and state laws.  

2) National coverage decisions made by Medicare about whether something is covered.

3) Local coverage decisions made by companies in each state that process claims for Medicare.

                    a. These companies decide whether something is medically necessary and should be covered in their area.

It’s almost impossible for one to know and understand each state’s rules and regulations as well as reimbursements that might be covered by each individual plan, so I recommend that you talk to your State Health Insurance Program (SHIP). Contact information is available at the “Contacts” link on the Medicare Website

www.medicare.gov/Contacts/

I know that most people want to live in their home for as long as one can...  Here are some things to remember about cost, housing, legal and home care.  It sounds like you are leaving your home to your guardian that is taking care of you.  Questions to consider is: Do you have the proper documentation to do this? Do you have a will or trust?  

I don't want to answer the question of selling your home directly because it depends on a few things that I don't know about you and your situation.  I want to provide you information so you can make an educated decision.  Facilities cost money.  The type of facility you choose will also depend on how much that will cost.  There are a limited number of beds (in facilities) that are available for people that have lower income. There are two types of facilities that could take you depending on your conditions and income.  

1) A skilled nursing facility.  Skilled nursing facility (SNF) also known as nursing homes or convalescent home, offers short term rehabilitative care. They provide around the clock long-term medical care to seniors with serious health problems. To qualify for services, the person needing services needs to have been an inpatient at the hospital for 3 nights (stays in the emergency room does not count). Secondly, you will need a physician order to qualify need of services.  How do you pay for a skilled nursing facility?  Services are paid through Medicare, Medicaid, your private health insurance, or out of pocket. Check with your individual insurance plans for coverage. Medicare pays for the first 20 days of stay, afterwards a co-pay is usually required up until the 100th day. When the 100 days are up, the individual is responsible for all costs. Please check with your facility about co-pay costs.

2) An assisted living facility. Senior housing option for those who need a wide range of non-medical in-home support services to help with activities of daily living, coordination of services by outside health providers, and monitoring resident activities to ensure their health and safety.  How do you pay for this type of facility? Payment is monthly and usually paid out of pocket or Long Term Care insurance; but some states have special need based programs that pay for a portion of the monthly fees. Payment is monthly and usually paid out of pocket or Long Term Care insurance; but some states have special need based programs that pay for a portion of the monthly fees. 

My answer to your question will be unsaid... As you can see there could be a need for money to be at either of these facilities.  But here is my thoughts moving forward.  You may not need to go to a facility.  Most of the services needed to remain in your home can be provided there.  

Home Healthcare provides medical services in the patient's residence.  To qualify for this service you must get your doctor’s order and be home bound, which essentially means it is extremely difficult for the senior to get around and out of the house. This service is usually covered by insurance such as Medicare, Medicaid or other private health insurances.

Hospice care is known as end-of-life care, as life expectancy is less than six months. A team of health care professionals and volunteers provides the service. They give medical, psychological, and spiritual support. The goal of the care is to help people who are dying have peace, comfort, and dignity. The caregivers try to control pain and other symptoms so a person can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's family.  Hospice service is traditionally covered under Medicare Part A.

Should you need money, you can always secure a reverse mortgage on your home.  If you’re 62 or older – and looking for money to pay for healthcare expenses – you may consider a reverse mortgage. It’s a product that allows you to convert part of the equity in your home into cash without having to sell your home or pay additional monthly bills.

Yes, in some states you must list your home for sale and use the proceeds to pay for nursing home care.  In other states, you can keep your home, but no income to maintain it and the State will place a lein on it when you die to pay back Medicaid.   You are well served to contact an elderlaw attorney in your state, and to have an assessment by a care manager to help you plan your next steps in your life.

In California, you do not have to sell your home to qualify for Medicaid as long as you have an intent to return to the house. However, Medi-Cal (California's Medicaid program) can recover against your estate after you pass, including outing an estate claim against the equity in your home. 

You will want to speak to an elder law attorney about your state's specific laws and legal ways (such as irrevocable trusts and irrevocable life estates) to protect the home after you pass.