Medicare covers rehabilitation for a limited time after you leave the hospital or enter a skilled nursing facility

Medicare Part A pays for inpatient rehabilitation in a skilled nursing facility (SNF) for up to 100 days per benefit period, but only if you meet specific conditions. You must have been admitted to a hospital for at least three consecutive days, been discharged to a SNF within 30 days, and need daily skilled nursing or therapy services that cannot be done at home. The length of your actual stay depends on your progress and medical need — Medicare does not automatically pay for all 100 days.

How long you stay is decided by your medical team and a utilization review process. Medicare reviews your case regularly to confirm you still need inpatient-level care. If your progress plateaus or you no longer need 24-hour skilled care, Medicare stops paying, even if you have days remaining in your 100-day benefit.

For rehabilitation at home or in an outpatient setting, Medicare Part B covers physical therapy, occupational therapy, and speech-language pathology services under different rules — there is no fixed number of days, but there are annual spending limits and medical necessity requirements.

Key Takeaways

  • Medicare Part A covers up to 100 days in a skilled nursing facility per benefit period, but only after a hospital stay of at least three consecutive days.
  • You pay nothing for days 1–20 of SNF care, $194.50 per day for days 21–100 (in 2024), and all costs after day 100.
  • Your actual length of stay depends on your medical progress and whether you continue to need skilled nursing or therapy — not on the number of days available.
  • Home-based rehabilitation through Medicare Part B has no day limit but is subject to annual spending caps and medical necessity reviews.
  • If you are discharged before day 100 and readmitted within 60 days, you use the same benefit period; after 60 days, a new benefit period begins.

The 100-Day Benefit Period and What It Actually Means

The 100 days is a maximum, not a may provide. Medicare will pay for your stay only as long as you need skilled care — meaning care that requires a licensed nurse or therapist to deliver safely and effectively. If your doctor determines you can manage at home with help from family or a home health aide, Medicare stops paying even if you have 50 days left.

A benefit period starts the day you are admitted to the hospital. If you are discharged and readmitted to a SNF within 60 days, you are still in the same benefit period and your day count continues from where it left off. If more than 60 days pass between discharge and readmission, a new benefit period begins and you get a fresh 100 days.

The utilization review team — usually a nurse employed by Medicare or your Medicare Advantage plan — checks your chart regularly. They look at whether you are making progress toward your rehabilitation goals, whether you still need round-the-clock nursing oversight, and whether your therapy is medically necessary. If the answer to any of these is no, they may deny further payment.

What You Pay During Your SNF Stay

Your out-of-pocket costs depend on which days you use. For 2024, Medicare Part A covers all costs for days 1 through 20 with no copay. On days 21 through 100, you pay $194.50 per day. After day 100, you pay the full cost of the facility.

These amounts change each year. Your SNF should give you a written estimate of your costs before or shortly after admission. If you have a Medigap (supplemental insurance) policy, it may cover some or all of your daily copay. If you have Medicaid as well as Medicare, Medicaid may pay your share after Medicare's coverage ends.

Do not assume the facility's bill is the same as what Medicare allows. Facilities that accept Medicare must accept Medicare's payment as payment in full for covered services. You should never be billed for the difference between what the facility charges and what Medicare pays.

How Medicare Decides When to Stop Paying

Medicare does not make the decision to end your coverage unilaterally. Your doctor and the SNF's care team recommend a discharge date based on your medical progress. If you or your family disagree with the decision to discharge you, you have the right to appeal.

You will receive a notice called the "Important Message About Your Rights" (also called the "Detailed Notice of Noncoverage") at least two days before Medicare stops paying. This notice explains why Medicare believes you no longer need inpatient SNF care and tells you how to request a review. You can ask for a peer-to-peer review, in which your doctor speaks directly with a Medicare medical reviewer to discuss your case.

If you request a review before the discharge date, you can stay in the facility while the review is happening without owing the daily copay. If the review upholds the discharge decision, you then owe for any days you stayed after the original discharge date.

Rehabilitation at Home Through Medicare Part B

If you are discharged from the SNF or hospital and still need therapy but can manage at home, Medicare Part B covers home health services and outpatient therapy. Home health services include skilled nursing, physical therapy, occupational therapy, and speech therapy — all delivered in your home by Medicare-approved providers.

Home health has no set number of days. Instead, Medicare pays for services as long as your doctor orders them and they are medically necessary. You must be homebound or have a medical reason that makes leaving home difficult. The frequency and duration of visits depend on your condition and progress.

For outpatient therapy — at a clinic, hospital, or therapist's office — Medicare Part B covers physical therapy, occupational therapy, and speech-language pathology. In 2024, you pay 20% of the cost after you meet your Part B deductible. There is no specific day limit, but Medicare tracks your spending and may require additional documentation if your therapy costs exceed certain thresholds.

What Happens If You Need Rehabilitation Beyond Medicare's Coverage

If you exhaust your 100 SNF days or your doctor says you need more therapy than Medicare will cover, you have several options. You can pay out of pocket, explore whether Medicaid covers additional days (if you are Medicaid-may be able to access), or transition to a lower level of care such as assisted living or home care paid privately.

Some people move to a rehabilitation hospital instead of a SNF. Rehabilitation hospitals are different from SNFs and have their own Medicare coverage rules. If your doctor believes you need the intensive therapy offered at a rehab hospital, ask whether Medicare will cover that setting instead.

If you have a Medicare Advantage plan, the coverage rules may differ from Original Medicare. Some plans offer additional rehabilitation benefits or different day limits. Contact your plan directly to understand what your specific plan covers.

Questions to Ask Your Doctor and Care Team

Before you are discharged from the hospital to a SNF, ask your doctor: "How many days do you expect I will need to stay?" and "What are my rehabilitation goals, and how will we know when I have reached them?" Ask the SNF's social worker or discharge planner about your out-of-pocket costs and whether your insurance will cover any of your daily copay.

If you receive a noncoverage notice, ask your doctor whether they believe you still need inpatient care and whether they will support an appeal. Ask the SNF's patient advocate or ombudsman to explain your appeal rights and help you understand the notice.

If you are nearing day 100, ask your care team what the plan is for after discharge — will you go home with home health services, to an outpatient therapy program, or to another setting? Understanding the transition plan ahead of time helps you prepare and arrange any services you will need to pay for yourself.

Frequently Asked Questions

Does Medicare cover rehabilitation in my home after I leave the hospital?

Yes, if your doctor orders home health services and you are homebound or have a medical reason that makes leaving home difficult. Medicare Part B covers physical therapy, occupational therapy, speech therapy, and skilled nursing in your home with no set day limit, as long as services remain medically necessary.

What if I am discharged from the SNF before day 100 and readmitted a month later?

If you are readmitted within 60 days, you are still in the same benefit period and your day count picks up where it left off. If more than 60 days pass between discharge and readmission, a new benefit period begins and you receive a fresh 100 days.

Can I stay in the SNF longer if I pay out of pocket?

Yes. Once Medicare stops paying, you can choose to stay and pay the facility's full daily rate yourself. The facility must tell you in writing when Medicare coverage ends and what you will owe if you stay. Some people use this time to continue therapy while arranging home care or other services.

Who decides when I am ready to leave the SNF?

Your doctor and the SNF's medical team make the recommendation based on your progress toward your rehabilitation goals and whether you still need 24-hour skilled care. If you disagree, you can request a peer-to-peer review before the discharge date takes effect.

Does my Medicare Advantage plan cover rehabilitation differently?

Medicare Advantage plans must cover at least what Original Medicare covers, but some offer additional benefits such as more therapy days or lower copays. Contact your plan to learn your specific coverage limits and any extra rehabilitation benefits you may have.