February 20th 2026
By Ari Parker
Understand what custodial care is, what services it includes, and whether Medicare or Medicaid covers it. Learn the key differences between custodial and skilled care.
Starting the search for custodial care can be an emotional and difficult milestone. Acknowledging that you, a parent, or a dear friend needs regular help with their everyday needs isn’t always easy, but finding the right care can make a significant difference in their ongoing quality of life.
Custodial care is a form of long-term care (LTC) support that provides non-medical care for individuals who need assistance with everyday tasks, like dressing or bathing. Unfortunately, custodial care is not covered by Medicare but may be covered by some state Medicaid programs.
In this article, we’ll cover the definition, examples, and costs of custodial care, how it differs from skilled care, and how to find and pay for it.
Custodial care includes forms of non-medical care, like assistance with dressing, eating, or bathing.
Unlike skilled care, custodial care is provided by non-licensed caregivers.
It’s important to interview and vet multiple sources when looking for custodial caregivers.
According to the Social Security Administration, custodial care is “designed essentially to assist an individual to meet the individual’s activities of daily living.” This may include personal care services like:
Assistance with bathing
Assistance with feeding
Assistance with toileting
Supervision of medication dispensation
Data from 2020 suggests that someone turning 65 years old today has nearly a 70% chance of needing some type of LTC service in their remaining lifetime, which may include custodial care.
Some seniors may require custodial care if they live with an ongoing physical disability or if they have a condition that affects their daily functioning, like dementia.
Custodial care and skilled nursing care, sometimes referred to as skilled care, are two different types of services.
Importantly, custodial care describes non-medical care usually performed by a non-licensed caregiver, whereas skilled care describes medical care performed by a licensed medical professional.
| Care | Type | Caregiver | Location | Covered by Medicare |
|---|---|---|---|---|
| Custodial | Non-medical | Non-licensed | At home or in a facility | No |
| Skilled | Medical | Licensed medical professional | At home or in a facility | Covered by Part A (short-term and only in a hospital or facility) |
Custodial care can be provided at home or in a facility including:
Nursing homes
Residential care facilities
Adult day care centers
Providers of custodial care are usually non-licensed caregivers. Examples of people who can provide custodial care include:
Home health aides
Personal care attendants
Unfortunately, Medicare does not cover LTC, including custodial care. Most Medigap plans also don’t cover custodial care.
Though Medicare doesn’t cover the cost of custodial care, you may be eligible for financial assistance through Medicaid. Eligibility requirements vary from state-to-state, so it’s best to check with your local Medicaid office to determine whether or not they can assist you in paying for the cost of custodial care.
You have several options when it comes to paying for custodial care, including:
Private pay: If your circumstances allow, you can choose to pay for custodial care out-of-pocket. This will be the most expensive option, but you’ll have the freedom to choose the service and caregiver you want.
LTC insurance: LTC insurance helps beneficiaries pay for different forms of LTC care, including custodial care. Policies vary depending on your coverage, but many plans offer reimbursement for custodial care for years.
Medicaid: Some state Medicaid services will pay for custodial care, but you must meet strict financial requirements. Most Medicaid services will cover custodial care administered in a nursing home or assisted living facility, but there are some states that may offer assistance with at-home custodial care for individuals who qualify.
Finding a custodial care provider is a highly personal endeavor. You want someone you can trust, who is able to provide the services you need, and who will get along with the recipient.
Keep in mind that for seniors looking for at-home care, it’s not uncommon to try out multiple custodial care providers before finding the right caregiver for their personality, lifestyle, and needs.
Working with an agency will help to take some of the guesswork and unpredictability out of your custodial caregiver search.
Most agencies perform background checks on all their employees and guarantee a quality and consistency of service. If your caregiver gets ill or cannot make their shift, most agencies will provide a stand-in.
However, working with a caregiver agency will cost more than finding the caregiver yourself.
When hiring an individual caregiver on your own, it’s a good idea to reach out to your friends, family, and larger network for referrals. This will help ensure that you find someone who is trustworthy and reliable.
If you or a loved one needs ongoing help with your daily needs, including feeding, bathing, dressing, or getting from point A to point B, a custodial caregiver can help.
Whether you receive care in-home or in a facility, a custodial caregiver helps their clients meet everyday needs with dignity.
Unfortunately, Medicare will not cover the cost of custodial care. But you may qualify for assistance through your state Medicaid program. Otherwise, there are long-term care insurance plans that can help.
Custodial care refers to non-medical care that helps an individual with their daily needs, like eating, bathing, or getting dressed.
Skilled nursing care refers to medical care performed by a licensed professional, whereas custodial care describes non-medical care often performed by an unlicensed caregiver or home health aide.
The cost of custodial care will vary depending on several factors, including where the care is performed. The average national cost of a home health aide in 2024 was $6,483 per month.
In some cases, custodial care may be tax-deductible. Mitigating factors include whether or not the custodial care was performed in a nursing home or assisted living facility. Please speak with a certified tax planner or otherwise professional for more advice on your possible tax deductions.
SSA - POMS: HI 00620.130 - Custodial Care - 11/04/2022. (2022, November 4). https://secure.ssa.gov/poms.nsf/lnx/0600620130
How much care will you need? | ACL Administration for Community Living. (n.d.). https://acl.gov/ltc/basic-needs/how-much-care-will-you-need
Skilled nursing facility care. (n.d.). Medicare. https://www.medicare.gov/coverage/skilled-nursing-facility-care
Long-term care. (n.d.). Medicare. https://www.medicare.gov/coverage/long-term-care
Cost of long term care by state | Cost of care Report | Carescout. (n.d.). https://www.carescout.com/cost-of-care
