Medicare covers inpatient rehabilitation in a skilled nursing facility (SNF) or inpatient rehabilitation hospital after a hospital stay, but only if specific conditions are met.
Medicare Part A pays for up to 100 days of skilled nursing care in a facility after you have been admitted to a hospital for at least three consecutive days. The facility must be Medicare-certified, and a doctor must order the care as medically necessary. You pay nothing for days 1–20, a copay of $194.50 per day for days 21–100 (as of 2024, though this amount changes yearly), and all costs after day 100.
Inpatient rehabilitation hospitals work the same way under Part A. The key word is inpatient — you must stay overnight. Outpatient rehab (physical therapy, occupational therapy, or speech therapy at a clinic or your home) is covered under Part B with a copay, but that is a different benefit and does not require a hospital stay first.
Key Takeaways
- Medicare Part A covers up to 100 days in a skilled nursing facility or inpatient rehabilitation hospital after a may have access to hospital stay of at least three consecutive days.
- You pay nothing for the first 20 days, then $194.50 per day (2024 rate) for days 21–100, and all costs after day 100.
- The facility must be Medicare-certified and a doctor must order the care as medically necessary for a specific condition.
- Outpatient rehab (therapy at home or a clinic) is covered under Part B with a copay and does not require a hospital stay first.
- Your hospital discharge planner can help identify Medicare-certified facilities and start the transfer process before you leave the hospital.
What "Medically Necessary" Means for Rehab Coverage
Medicare does not cover rehab straightforward because you had surgery or spent time in the hospital. A doctor must document that you need skilled nursing care — meaning care that requires a nurse or therapist to deliver it — for a condition that arose or worsened during your hospital stay.
Common reasons Medicare covers post-hospital rehab include recovery from hip or knee replacement, stroke, heart attack, pneumonia, or a fall that caused a fracture. The condition must be one that improves with therapy, and your progress must be measurable. If you are stable and no longer improving, Medicare may stop paying even if you have days left in your 100-day benefit.
Your doctor and the facility's medical team decide whether care remains medically necessary. If Medicare denies coverage partway through your stay, the facility must notify you in writing and explain your right to appeal.
How to Arrange Rehab Before Leaving the Hospital
Before you are discharged, ask to speak with the hospital's discharge planner. This person's job is to arrange your next level of care and confirm that any facility you transfer to accepts Medicare. Tell them you have Medicare and ask them to identify skilled nursing facilities or inpatient rehabilitation hospitals in your area that are Medicare-certified.
The discharge planner will contact facilities on your behalf, check bed availability, and arrange the transfer. They will also send your medical records ahead so the new facility knows your diagnosis, medications, and therapy needs. This usually happens within 24 hours of your discharge date.
If you prefer a specific facility — perhaps one close to family or where a friend received care — tell the discharge planner. They will try to place you there if it is Medicare-certified and has a bed available. If your preferred facility is full, ask to be put on a waiting list.
The Difference Between Skilled Nursing Facilities and Inpatient Rehab Hospitals
A skilled nursing facility (SNF) is usually attached to or near a hospital. It provides nursing care, medication management, and therapy (physical, occupational, and speech). Most people go to an SNF after a hospital stay. The environment is less intensive than a hospital — you have your own room or share one, and staff respond to call buttons rather than monitoring you continuously.
An inpatient rehabilitation hospital is a separate hospital focused entirely on therapy and recovery. It is used when you need more intensive rehabilitation — for example, after a severe stroke or spinal cord injury. You receive several hours of therapy per day and are monitored more closely. Medicare covers both under the same rules: three-day hospital stay first, then up to 100 days of coverage.
Your doctor and the discharge planner decide which setting is right for you based on how much therapy you need and how quickly you are expected to recover. Both are covered the same way by Medicare Part A.
What Happens If You Run Out of Coverage
If you need rehab beyond 100 days, you become responsible for all costs unless you have a supplemental insurance plan (Medigap) or Medicaid. Some Medigap plans cover some or all of the copays for days 21–100, and a few cover costs after day 100, but coverage varies by plan. Check your policy or call your insurance company to find out what you have.
Medicaid covers long-term skilled nursing care for people who meet income and asset limits, but rules vary by state. If you are running low on days and think you may need Medicaid, ask the facility's social worker to help you understand your state's rules and whether you might be may be able to access.
Some facilities offer private-pay rates if you stay beyond your Medicare benefit. Ask the facility's billing department what the daily rate is and whether they offer a discount for longer stays.
Outpatient Rehab as an Alternative
If you do not meet the requirements for inpatient rehab — for example, if you did not spend three days in the hospital, or if your doctor thinks you can recover at home — Medicare Part B covers outpatient therapy. This includes physical therapy, occupational therapy, and speech therapy at a clinic, hospital outpatient department, or your home.
Part B covers these services with a copay (usually 20% of the approved amount after you meet your deductible). There is no limit on the number of visits, though Medicare may review your progress and stop paying if you are not improving. Home health care — a nurse or therapist visiting your home — is also covered under Part A if a doctor orders it and you are homebound.
Outpatient rehab is often less expensive than inpatient care and lets you recover in a familiar setting. Ask your doctor whether outpatient therapy might work for you before committing to an inpatient facility.
Questions to Ask Before You Transfer
Before you leave the hospital, write down the name and phone number of the facility you are transferring to, the name of your assigned nurse or care coordinator, and the expected length of stay. Ask the discharge planner to explain your copay responsibility and confirm that the facility is Medicare-certified.
Once you arrive at the facility, ask to meet with the physical or occupational therapist to understand your therapy schedule and goals. Ask how often you will see a doctor and how progress is measured. If you have questions about your bill or coverage, ask to speak with the billing department before problems arise.
If you feel you are not making progress or that the facility is not meeting your needs, tell your doctor or the facility's administrator. You have the right to transfer to another Medicare-certified facility if you choose, though you will need a new doctor's order.
Frequently Asked Questions
Do I have to go to a skilled nursing facility after the hospital, or can I go straight home?
You can go home if your doctor thinks you are safe and able to manage your recovery there. If you need skilled nursing care or intensive therapy, your doctor will recommend a facility. The choice is yours, but Medicare only pays for facility care if a doctor orders it as medically necessary.
What if the facility says I am not making enough progress and they want to discharge me early?
The facility must notify you in writing before discharging you for lack of progress. You have the right to appeal this decision. Ask to speak with the facility's social worker or patient advocate, or call Medicare at 1-800-MEDICARE to ask about your appeal options.
Does Medicare cover rehab if I did not spend three full days in the hospital?
No. The three-day hospital stay is a requirement for inpatient rehab coverage. If you spent only one or two days in the hospital, you do not meet this rule. You may still be able to receive outpatient therapy at home or a clinic under Part B.
Will my supplemental insurance (Medigap) pay the copays for skilled nursing care?
Some Medigap plans cover part or all of the copays for days 21–100 in a skilled nursing facility. Check your policy documents or call your insurance company to find out what your plan covers. Plans vary widely.
Can I choose which skilled nursing facility I go to?
Yes. Tell your discharge planner your preference, and they will try to place you there if it is Medicare-certified and has a bed available. If your first choice is full, ask to be added to a waiting list or ask for recommendations for other nearby facilities.