Medicare covers rehabilitation for up to 100 days in a skilled nursing facility after a hospital stay, but the length of payment depends on your progress and medical need.

Medicare Part A pays for inpatient rehabilitation in a skilled nursing facility (SNF) only after you have spent at least three consecutive nights in a hospital for the same condition. The clock starts on day one of your SNF stay. Days 1–20 are fully covered with no out-of-pocket cost to you. From day 21 onward, you pay a daily coinsurance amount (this varies yearly but is typically several hundred dollars per day). After day 100, Medicare stops paying, and you are responsible for all costs unless another payer takes over.

The key word is skilled care. Medicare does not pay for custodial care — help with bathing, dressing, or daily living — unless it is part of a skilled nursing or rehabilitation service. A physical therapist working with you counts as skilled care. A nurse monitoring your wound or adjusting medications counts. A staff member helping you shower does not, unless you are there primarily for skilled services.

Key Takeaways

  • Medicare Part A covers up to 100 days in a skilled nursing facility per benefit period, but only after a may have access to three-night hospital stay for the same condition.
  • You pay nothing for days 1–20; from day 21 onward you pay a daily coinsurance amount that Medicare sets each year.
  • Coverage ends if your doctor determines you no longer need skilled care, even if you have days remaining in your 100-day window.
  • Rehabilitation in your home (home health) is covered separately and does not count against your 100-day SNF limit.
  • If you are discharged and later readmitted to a hospital for a new condition, a new three-night stay starts a new benefit period and resets your 100-day count.

When the 100 days clock starts and stops

Your SNF stay must follow a hospital admission. You cannot go directly from home to a skilled nursing facility and have Medicare pay for it. You must be admitted to a hospital as an inpatient (not observation status) and stay for at least three consecutive nights. The third night must end before midnight on the third calendar day. If you are discharged on day three, that counts; if you leave on day two, it does not.

Once you meet the three-night requirement, your SNF coverage begins on the day you are admitted to the facility. Day 1 of your SNF stay is the first day you are physically there. The 100-day limit is per benefit period, which usually runs from October 1 to September 30 of the following year, though it can reset earlier if you have a new may have access to hospital stay for a different condition.

Your coverage can end before day 100 if your doctor determines you no longer need skilled nursing care. Medicare does not pay for continued SNF stays once the medical need for skilled services ends, even if you have days left. The facility must notify you in writing before discharge, and you have the right to appeal if you disagree.

What happens on days 21 through 100

Days 1–20 are fully covered by Medicare Part A with no coinsurance. Starting on day 21, you owe a daily coinsurance amount. In 2024, this amount is $194.50 per day, but it changes each year. Some supplemental insurance plans (Medigap) cover part or all of this coinsurance, so check your policy. Medicare Advantage plans may have different cost-sharing rules, so contact your plan directly.

You remain responsible for this daily amount for each day you stay in the SNF from day 21 through day 100. If you stay all 100 days, you will owe coinsurance for 80 days. After day 100, you pay the full cost of the facility unless you have other insurance or may have access to for Medicaid.

Home health rehabilitation and how it differs

If you are discharged from the hospital or SNF and need rehabilitation at home, Medicare Part A covers home health services under a separate benefit. Home health does not count toward your 100-day SNF limit. You can receive physical therapy, occupational therapy, speech therapy, and nursing care at home, and Medicare covers these services as long as your doctor orders them and you meet the homebound requirement (you are unable to leave home without considerable effort or help).

Home health is covered with no daily limit, but only for the length of time your doctor says you need skilled care. Once your therapist or nurse determines you no longer need skilled services, coverage ends. Home health is also covered at no cost to you — you do not pay a daily coinsurance like you do in a SNF after day 20.

What happens if you need more than 100 days

If you exhaust your 100 days and still need skilled care, you have several options. Some people transition to home health if they are medically appropriate and meet the homebound requirement. Others continue in the SNF but pay out of pocket. Some facilities offer a lower rate for private-pay patients, though this varies widely.

If you have Medicaid in addition to Medicare, Medicaid may cover SNF care after Medicare ends, but this depends on your state and your Medicaid status. Contact your state Medicaid office to learn whether you are covered. If you have a long-term care insurance policy, check whether it covers SNF stays and what the daily benefit is.

Another option is to be discharged and then readmitted to a hospital for a new condition. If you spend three nights in the hospital for a different medical issue, you start a new benefit period and get a fresh 100-day SNF benefit. However, do not plan your care around this — readmission decisions must be based on medical need, not on resetting your benefit.

Observation status versus inpatient admission

A common source of confusion is the difference between observation status and inpatient admission. If you are in the hospital on observation status, those days do not count toward the three-night requirement for SNF coverage. Observation is typically used for patients the hospital expects to discharge within 24 hours, though they may stay longer. Inpatient admission is what you need.

Ask your hospital care team directly: "Am I admitted as an inpatient or on observation status?" If you are on observation and your stay extends beyond a few days, ask whether your status can be changed to inpatient. This matters because it determines whether your SNF stay will be covered. If you are discharged from observation without being admitted as an inpatient, Medicare will not pay for a subsequent SNF stay.

How to find out how many days you have left

When you are admitted to a SNF, the facility's billing department should explain your coverage and how many days you have remaining. You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227) and ask about your benefit. Have your Medicare card ready.

You can also view your benefits online through your Medicare account at Medicare.gov. Log in, go to "My Health and Wellness," and look for information about your inpatient hospital and SNF benefits. If you have a Medigap or Medicare Advantage plan, contact your plan's customer service line — they can tell you your remaining days and your out-of-pocket costs.

Frequently Asked Questions

Does observation status in the hospital count toward my three-night requirement?

No. Only nights spent as an inpatient admission count. If you are on observation status, those days do not may have access to you for SNF coverage, even if you stay in the hospital for many days. Ask your hospital team to clarify your status before discharge.

If I go home after the hospital and then need SNF care later, do I get another 100 days?

Only if you are readmitted to the hospital as an inpatient for three nights for a new condition. If you go home and later need SNF care for the same condition you were hospitalized for, you are still in the same benefit period and your 100-day count continues from where it left off.

Can I appeal if Medicare says I no longer need skilled care?

Yes. The SNF must give you written notice before discharge. You have the right to request an when ready review by Medicare, and you can appeal the decision. Contact your SNF's patient advocate or call Medicare at 1-800-MEDICARE for information about the appeal process.

What if I have both Medicare and Medicaid?

Medicare pays first up to 100 days. After that, Medicaid may cover continued SNF care if you are Medicaid-may be able to access in your state. Contact your state Medicaid office to confirm your coverage and any requirements.

Does my Medigap plan cover the coinsurance after day 20?

Many Medigap plans cover part or all of the daily coinsurance from day 21 onward, but it depends on which plan you have. Check your policy documents or call your Medigap insurer to confirm what they cover.