What Medicare Covers and For How Long

Medicare Part A covers up to 100 days in a skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF) per benefit period, but you will not use all 100 days in most cases. The length of your actual stay depends on your medical condition, your progress in therapy, and whether your doctor believes you still need skilled care. Medicare stops paying when you no longer require daily skilled nursing or therapy — not when you reach a calendar important date.

The first 20 days are fully covered by Medicare Part A with no cost to you. From day 21 through day 100, you pay a daily coinsurance amount (the amount changes each year; ask your facility or call Medicare at 1-800-MEDICARE for the current figure). After day 100 in a single benefit period, Medicare coverage ends and you or your supplemental insurance must pay the full cost.

A benefit period begins the day you enter the hospital and ends 60 days after you leave the hospital or skilled nursing facility with no readmission. If you are readmitted after that 60-day window, a new benefit period starts and you have another 100 days of coverage.

Key Takeaways

  • Medicare Part A covers up to 100 days per benefit period, but your actual stay length is determined by medical need, not the calendar limit.
  • Days 1–20 are fully covered; days 21–100 require you to pay a daily coinsurance amount that Medicare sets each year.
  • Your doctor and the facility's care team decide when you are ready to leave based on your progress in therapy and your ability to manage at home.
  • If you are readmitted to the hospital more than 60 days after discharge, a new benefit period begins and you get another 100 days of coverage.
  • Medigap supplemental insurance can cover some or all of the daily coinsurance you owe on days 21–100.

How Your Doctor and the Facility Decide When You Leave

Medicare does not set a fixed discharge date. Instead, your care team — your doctor, physical therapist, occupational therapist, and nursing staff — meets regularly to assess whether you still need skilled care. Skilled care means daily nursing services, physical therapy, occupational therapy, or speech therapy that requires a licensed professional. If you can safely manage your medications, meals, and mobility at home, or if you have reached a plateau in your recovery, the team will recommend discharge even if you have days remaining.

You have the right to ask questions about the discharge plan and to request a second opinion from your doctor if you disagree. If you believe you are being discharged too early, you can file an appeal with Medicare — the facility must give you written notice at least two days before discharge, and that notice includes instructions for appealing.

What Happens If You Need Care Beyond 100 Days

If you exhaust your 100 days of Medicare coverage and still need skilled care, you have several options. Some people transition to a lower level of care, such as home health services, which Medicare may cover if a doctor orders them and you are homebound. Others move to a long-term acute care hospital (LTACH) if they have complex medical needs, though Medicare coverage rules differ for that setting.

If you need custodial care — help with daily activities like bathing or dressing but not skilled nursing — Medicare does not cover it. You would need to pay out of pocket, use Medicaid if you may have access to, or rely on family support. Some facilities offer private-pay beds for residents who have exhausted Medicare coverage.

Understanding Benefit Periods and Readmission

Your benefit period is tied to your hospital stay, not the calendar year. It begins the day you are admitted to the hospital and ends 60 days after you are discharged from the hospital or skilled nursing facility without being readmitted. If you go home on day 50 and stay home for 60 days, your benefit period closes. If you are readmitted to the hospital on day 61, a brand-new benefit period starts, and you have another 100 days of skilled nursing or rehabilitation coverage.

This matters because some people need multiple stays in a single year. If you are discharged, recover at home, and then fall or have a setback that requires hospitalization again, you may have a fresh 100 days available. However, if you are readmitted within 60 days, you are still in the same benefit period and your 100-day clock does not reset.

Daily Coinsurance Costs on Days 21 Through 100

Medicare Part A requires you to pay a daily coinsurance amount for days 21 through 100 of your stay. This amount is set by Medicare each year and covers your room, meals, and basic care. In 2024, this daily amount is $194.50, but confirm the current year's amount with your facility or Medicare before your stay begins.

If you have a Medigap supplemental insurance plan (also called Medigap), it may cover some or all of this daily coinsurance. Plans C, D, F, and M typically cover the full coinsurance; other plans cover part of it. Check your Medigap policy documents or call your insurance company to see what you owe. If you do not have Medigap and cannot afford the coinsurance, ask the facility's financial counselor about payment plans or whether you might be may be able to access for Medicaid to cover the gap.

What to Ask Your Doctor and Facility Before Admission

Before you enter a rehabilitation facility, ask your doctor how long they expect your stay to be and what milestones you need to reach before discharge. Ask the facility's admissions staff what your daily coinsurance will be and whether your Medigap plan covers it. Request a written summary of the discharge criteria — what skills or abilities you need to demonstrate to go home safely.

Ask whether the facility accepts Medicare and whether it is certified as a skilled nursing facility or inpatient rehabilitation facility, because coverage rules differ slightly between the two. If you have questions during your stay about your progress or discharge timeline, speak up — your care team should be transparent about your goals and your readiness to leave.

When to Contact Medicare or Your Facility

Call Medicare at 1-800-MEDICARE if you want to know the current daily coinsurance amount, if you have questions about your benefit period, or if you believe you are being discharged prematurely and want to file an appeal. Call your facility's patient advocate or social worker if you have concerns about your care plan, your discharge date, or how to pay for days 21–100.

If you are approaching day 100 and your doctor believes you still need skilled care, ask about transitioning to home health services or another covered setting. Do not wait until day 100 to have this conversation — planning ahead gives you time to arrange support at home or explore other options.

Frequently Asked Questions

Can I stay longer than 100 days if I pay out of pocket?

Yes. Once Medicare coverage ends at day 100, you can remain in the facility and pay privately if the facility agrees and you can afford it. Some facilities have private-pay beds available. Discuss this option with the admissions or financial staff before you reach day 100.

Does Medicare cover rehabilitation at home instead of a facility?

Yes, if your doctor orders home health services and you are homebound (unable to leave home without considerable effort). Home health can include physical therapy, occupational therapy, and nursing care. Coverage rules and duration differ from facility-based rehabilitation, so ask your doctor whether home health is an option for your situation.

What if I am readmitted to the hospital during my rehabilitation stay?

If you are hospitalized while in a skilled nursing facility, your days in the SNF may pause or your benefit period may be affected depending on the circumstances. Ask the facility and your hospital to explain how the readmission affects your coverage. This is complex enough that it is worth a phone call to Medicare or your Medigap insurer to clarify.

Do I have to pay the daily coinsurance if I have Medicaid?

Medicaid can cover the daily coinsurance on days 21–100 if you are may be able to access for both Medicare and Medicaid (called "dual may be able to access"). Contact your state Medicaid office or your facility's social worker to find out whether you may have access to and how to enroll.

What happens to my Medicare coverage if I am in a rehabilitation facility on January 1?

Your coverage does not change. Medicare benefit periods are based on hospital admission dates, not the calendar year. Your 100-day clock continues to run regardless of the date.