Medicare Part A covers skilled nursing facility care after a hospital stay

Yes, Medicare Part A covers skilled nursing facility (SNF) care, but only under specific conditions. You must have been admitted to a hospital for at least three consecutive days, then move directly to a Medicare-approved SNF within 30 days of leaving the hospital. The care you receive must be for the same condition you were treated for in the hospital, or a condition that developed during your hospital stay.

Medicare Part A pays for your room, meals, nursing care, therapy, and medical equipment while you are in the facility. You do not pay a facility fee or daily copay for the first 20 days. From day 21 through day 100, you pay a daily coinsurance amount (this amount changes each year). After day 100 in the same benefit period, Medicare stops paying and you are responsible for all costs.

A benefit period begins the day you enter the hospital and ends 60 days after you leave the SNF with no hospital or SNF stays in between. If you return to the hospital and then to a SNF, a new benefit period starts.

Key Takeaways

  • Medicare Part A covers SNF care only if you spent at least three days in a hospital first and move to the facility within 30 days.
  • The first 20 days are fully covered by Medicare Part A; days 21–100 require you to pay a daily coinsurance amount.
  • The SNF must be Medicare-approved and the care must relate to your hospital diagnosis or a condition that arose during your hospital stay.
  • Coverage ends after 100 days in a single benefit period, and a new benefit period begins only after you leave the SNF and hospital for at least 60 days.

What counts as a three-day hospital stay

The three days must be consecutive days as an inpatient in the hospital. Observation status does not count, even if you spend three calendar days in the hospital. Observation means you are being monitored but not formally admitted as an inpatient. Ask the hospital directly whether you are an inpatient or in observation status — this is the single most common reason people believe they may have access to for SNF coverage when they do not.

The three days include the day you are admitted and the day you are discharged. If you enter on a Monday and leave on Wednesday, that counts as three days. Partial days do not extend the count — you need three full calendar days.

Which skilled nursing facilities Medicare will pay

The facility must be Medicare-approved. You can search for Medicare-approved SNFs on the Medicare.gov website under "Care Compare" or call 1-800-MEDICARE to ask whether a specific facility is approved. Not all nursing homes are skilled nursing facilities — some are custodial care facilities, which Medicare does not cover.

The difference matters: a skilled nursing facility provides skilled nursing care (wound care, medication management, physical therapy) ordered by a doctor. A custodial care facility provides help with daily living (bathing, dressing, eating) but not skilled medical care. If the facility cannot provide the specific skilled care your doctor ordered, Medicare will not pay, even if the facility is otherwise approved.

What happens when your 100 days end

After 100 days of SNF care in a single benefit period, Medicare Part A stops paying. You then owe all costs out of pocket unless you have supplemental insurance (Medigap) or Medicaid. Some Medigap plans cover part of the daily coinsurance during days 21–100, but none cover costs after day 100.

If you need continued care after day 100, talk to the SNF social worker about payment options. Some facilities offer private-pay rates, or you may be able to move to a different level of care. If your income is very low, you may be able to explore for Medicaid, which covers nursing home care without a 100-day limit, though rules vary by state.

The difference between SNF coverage and home health coverage

Medicare Part A also covers home health care after a hospital stay, and the rules are different. Home health does not require a three-day hospital stay in most cases — it requires that your doctor order it and that you are homebound. Home health is covered for as long as your doctor orders it, with no 100-day limit.

If you are strong enough to go home with help, home health may be a better option than a SNF because it has no time limit. If you need 24-hour supervision or intensive skilled care, a SNF is usually necessary. Your hospital discharge planner can help you understand which option fits your situation.

What you pay out of pocket

For days 1–20, you pay nothing if you meet the three-day hospital requirement. For days 21–100, you pay a daily coinsurance amount set by Medicare each year. In 2024, that amount is $200 per day, but this changes annually. Your SNF will tell you the exact amount you owe when you arrive.

You are also responsible for any care or services Medicare does not cover, such as phone, television, or private room upgrades. If the SNF provides care that is not medically necessary (such as personal grooming beyond what your condition requires), you may be billed for that separately.

If you have a Medigap plan, it may cover some or all of the daily coinsurance during days 21–100. Check your plan documents or call your Medigap insurer to confirm what they cover.

Questions to ask your hospital before discharge

Before you leave the hospital, ask the discharge planner: "Am I being discharged as an inpatient or observation status?" If observation, ask whether the doctor will change your status to inpatient before you leave. Ask which SNFs are Medicare-approved and accept your insurance. Ask whether your condition requires SNF care or whether home health would work instead.

Get a written list of the skilled care your doctor is ordering — this is what the SNF will use to determine whether Medicare will pay. Ask the SNF directly whether they expect Medicare to cover your stay and for how long. Do not assume the hospital's answer is the same as the SNF's answer; they may disagree on whether the care is skilled.

Frequently Asked Questions

What if I was in observation status, not admitted as an inpatient?

You do not meet the three-day inpatient requirement, and Medicare Part A will not cover SNF care. However, you may still be covered for home health if your doctor orders it and you are homebound. Ask the hospital to review your status before discharge — sometimes it can be changed if your condition warrants inpatient admission.

Can Medicare cover a SNF stay that is not right after a hospital stay?

No. The SNF stay must begin within 30 days of hospital discharge. If you go home first and then need a SNF later, Medicare will not pay unless you have another hospital stay of at least three days first.

What if the SNF says Medicare will only cover 30 days, not 100?

The SNF is making a prediction based on your progress, not setting a limit. Medicare will pay up to 100 days if your doctor continues to order skilled care. If the SNF stops recommending skilled care before day 100, they will discharge you, and Medicare will stop paying. You can ask for a detailed explanation of why they believe you no longer need skilled care.

Does Medicare cover a SNF stay for rehabilitation after a fall or surgery?

Yes, if you were hospitalized for at least three days for the fall or surgery and move to a Medicare-approved SNF within 30 days. The SNF must provide skilled care such as physical therapy ordered by your doctor. Rehabilitation alone, without skilled nursing care, does not may have access to.

What if I cannot afford the daily coinsurance on days 21–100?

Talk to the SNF social worker about Medicaid, which may cover the coinsurance if your income and assets are low enough. Rules vary by state. If you have a Medigap plan, check whether it covers the coinsurance. Some SNFs also offer financial information programs or payment plans.