How long Medicare pays for rehab depends on your medical need and progress, not a set calendar limit

Medicare does not have a fixed number of days it will pay for rehabilitation. Instead, it covers rehab in a skilled nursing facility (a facility with nurses and therapists on staff) for as long as your doctor says you need it to recover from an illness or injury — up to 100 days per benefit period. The length of your actual stay depends on your condition, how well you are improving, and whether Medicare's medical reviewers agree the care is still necessary.

A benefit period starts the day you enter the hospital and ends 60 days after you leave. If you need rehab again later, a new benefit period begins, and you get another 100 days of coverage. The catch is that Medicare stops paying once you reach your improvement plateau — the point where therapy is no longer helping you regain function. At that point, you move to custodial care, which Medicare does not cover.

Key Takeaways

  • Medicare covers up to 100 days of skilled nursing facility care per benefit period, but only while your condition is improving and your doctor orders continued therapy.
  • The first 20 days are covered at 100 percent after you meet your Part A deductible; days 21 through 100 require a daily copay of around $200 (the amount changes yearly).
  • Medicare stops paying when your progress plateaus, even if days remain, because the goal is recovery, not long-term care.
  • Your doctor and the facility's medical team decide when you are ready to leave, not Medicare directly, but Medicare's reviewers can deny payment if they believe care is no longer medically necessary.
  • If you need rehab again after you leave, a new benefit period begins only if you have been out of the hospital for 60 days or more.

What counts as a skilled nursing facility under Medicare

Medicare only pays for rehab in a skilled nursing facility — not in a regular nursing home, assisted living, or your own home. A skilled nursing facility has registered nurses and licensed therapists (physical, occupational, or speech) available around the clock. The facility must be Medicare-certified, which you can check on Medicare.gov or by calling 1-800-MEDICARE.

Some hospitals have skilled nursing units attached to them. Others are standalone buildings. Either way, the rules are the same: you must have been hospitalized for at least three consecutive days (not counting the day you leave) before Medicare will cover a skilled nursing stay. If you go straight from home or an emergency room to a nursing facility without a hospital stay, Medicare will not pay.

How the 100-day limit actually works

The 100 days are per benefit period, not per year. A benefit period runs from the day you enter the hospital through 60 days after you leave the hospital. If you are readmitted to the hospital more than 60 days after your first discharge, a new benefit period starts, and you get another 100 days of skilled nursing coverage.

Within those 100 days, your coverage breaks into two tiers. Days 1 through 20 are fully covered (after you pay your Part A deductible, which is $1,600 in 2024, though this amount changes yearly). On days 21 through 100, you pay a daily copay — around $200 per day in 2024. If you stay all 100 days, your out-of-pocket cost for days 21 through 100 alone will be roughly $16,000, plus your initial deductible.

Many people do not stay the full 100 days. The average skilled nursing stay is 20 to 30 days. You leave when your doctor believes you have recovered enough to go home, to assisted living, or to another level of care — or when Medicare's reviewers decide you are no longer making progress.

When Medicare stops paying before day 100

Medicare will stop covering your stay if you reach what is called your plateau — the point where you are no longer improving enough to justify skilled care. This is not a sudden decision. Your therapy team meets regularly to measure your progress. If your strength, mobility, or ability to perform daily tasks stops improving, Medicare's reviewers may deny further payment.

You will receive written notice if Medicare denies payment for continued stay. The notice explains why and tells you that you have the right to appeal. If you disagree, you can request a review, and a Medicare contractor will look at your medical records and progress notes. Many appeals succeed if your medical team can document that you are still making meaningful gains.

Even if Medicare denies payment, you can stay at the facility and pay out of pocket. Some people do this for a few extra days to finish therapy or arrange transportation home. The facility must tell you in writing that Medicare will no longer pay before they can charge you directly.

What happens after your 100 days end or Medicare stops paying

Once your skilled nursing coverage ends, you have several options. You can go home with outpatient therapy (physical therapy or occupational therapy at a clinic or at home). You can move to assisted living, which is not covered by Medicare but may be covered by Medicaid if you may have access to. You can also stay in the nursing facility and pay privately, though this is expensive — skilled nursing facilities typically cost $300 to $500 per day or more, depending on your location and the facility.

If you need rehab again later, the timing matters. If you have been out of the hospital for 60 days or more, a new benefit period begins, and you get another 100 days of coverage. If you are readmitted within 60 days, you are still in the same benefit period, and your remaining days are what you have left from your original 100.

How to find out how many days you have left

Your skilled nursing facility's billing department can tell you exactly how many days Medicare has approved and how many you have used. Ask for this information in writing so you have a record. You can also call 1-800-MEDICARE and give them your Medicare number; they can look up your benefit period and remaining days.

Keep in mind that the number Medicare approves at the start of your stay is not final. Approvals are often given in blocks — for example, 14 days initially, then another 14 days if your progress continues. This means you may not know your full 100 days are approved until you are well into your stay. Ask your facility to tell you whenever Medicare approves additional days.

Medigap and Medicare Advantage coverage for rehab costs

If you have a Medigap policy (supplemental insurance), it may cover some or all of your daily copays for days 21 through 100. The amount depends on which Medigap plan you have. Plans C, D, F, and G typically cover the copay; Plans A and B do not. Check your policy documents or call your Medigap insurer to confirm.

If you have Medicare Advantage (Part C), your coverage for skilled nursing is different. Most Medicare Advantage plans cover up to 100 days, but some cover fewer. Your plan may also require you to use facilities in its network. Check your plan documents or call the plan's customer service line before you need rehab so you know what to expect.

Questions to ask your doctor and the facility

Before you enter a skilled nursing facility, ask your doctor: "How long do you expect I will need rehab?" and "What will we measure to know when I am ready to leave?" These answers help you understand the goal and what progress looks like.

When you arrive at the facility, ask the billing department: "How many days has Medicare approved?" and "Will you tell me if Medicare approves more days or denies further payment?" Ask your therapy team: "What are my therapy goals, and how often will we measure my progress?" This keeps you informed and helps you spot problems early if progress stalls.

Frequently Asked Questions

Can I stay in rehab longer than 100 days if I am still improving?

No. The 100-day limit per benefit period is a hard cap. If you are still improving after 100 days, you will need to pay privately or transition to outpatient therapy. A new benefit period (and another 100 days) only begins if you are readmitted to the hospital and have been out for at least 60 days since your last discharge.

What if I do not improve fast enough and Medicare stops paying before day 100?

You can appeal Medicare's decision. Request a review in writing within the timeframe given in your denial notice. Your doctor and therapy team can submit progress notes and argue that you are still making meaningful gains. If the appeal is denied, you can pay out of pocket to stay or transition to outpatient care at home or a clinic.

Does Medicare cover rehab at home instead of a facility?

Medicare covers home health therapy (physical therapy, occupational therapy, or speech therapy) only if you are homebound and a doctor orders it. Home health is not the same as skilled nursing facility care and has different rules. It is usually shorter-term and less intensive than facility-based rehab.

If I have Medicare Advantage, do the same 100-day rules explore?

Most Medicare Advantage plans cover up to 100 days of skilled nursing, but some cover fewer days. Your plan may also require you to use in-network facilities. Check your plan documents or call customer service before you need rehab to know your exact coverage and any facility restrictions.

What if I need rehab twice in one year?

You get 100 days per benefit period. If your first rehab stay ends and you are discharged from the hospital, a new benefit period begins 60 days after that discharge. At that point, you have another 100 days of coverage. If you are readmitted to the hospital within 60 days of your first discharge, you are still in the same benefit period and have only your remaining days from the original 100.