Medicare covers up to 100 days of inpatient rehabilitation per benefit period, but you will pay nothing for the first 20 days and a copay for days 21 through 100

The number of days Medicare will pay for depends on whether you need skilled nursing facility (SNF) care or inpatient rehabilitation facility (IRF) care, and it resets each time you enter a new benefit period. A benefit period begins the day you are admitted to a hospital and ends 60 days after you leave the hospital or skilled nursing facility without being readmitted. If you are readmitted within those 60 days, you stay in the same benefit period. If you wait 60 days or longer before returning, a new benefit period starts.

Medicare Part A (hospital insurance) is what covers these rehabilitation days. You must have been admitted to a hospital for at least three consecutive days before Medicare will cover a transfer to a rehabilitation facility. The facility itself must be Medicare-certified, which most major rehabilitation centers are, but you should confirm this before admission.

Key Takeaways

  • Medicare covers up to 100 days of inpatient rehabilitation per benefit period, with no copay for days 1–20 and a daily copay for days 21–100.
  • You must spend at least three consecutive days in a hospital before Medicare will cover rehabilitation facility care.
  • A benefit period resets 60 days after you leave the hospital or rehabilitation facility without being readmitted.
  • Medicare reviews your progress regularly and may stop covering your stay if you are not making measurable improvement toward your rehabilitation goals.
  • The facility must be Medicare-certified, and your doctor must order the rehabilitation as medically necessary.

What happens after your 20 free days

For days 1 through 20 of your inpatient rehabilitation stay, you pay nothing beyond your Part A deductible (which you pay once per benefit period when you enter the hospital). Starting on day 21, you owe a daily copay. The copay amount changes each year; in 2024 it is $194.50 per day, but you should contact Medicare or your facility to confirm the current amount.

You continue to pay this daily copay through day 100. After day 100 in the same benefit period, Medicare stops paying, and you become responsible for the full cost of care. This is why it matters whether your rehabilitation is progressing — if you are not improving, the facility may discharge you before day 100 to avoid costs you cannot pay.

If you have a Medigap policy (supplemental insurance), it may cover some or all of your copays for days 21–100, depending on which plan you hold. If you have Medicare Advantage, your plan may cover rehabilitation differently — some plans cover the full 100 days with lower copays, while others impose stricter limits. Check your plan documents or call your plan's member services line to know what you will owe.

How Medicare decides when to stop paying

Medicare does not automatically pay for all 100 days. A doctor at the rehabilitation facility must certify that you need skilled nursing care or intensive rehabilitation, and your progress is reviewed regularly — typically every few days in the first week, then weekly. If you stop making measurable progress toward your rehabilitation goals, the facility may discharge you even if you have days remaining.

Progress means different things depending on your condition. For someone recovering from a stroke, it might mean regaining the ability to walk or speak. For someone with a broken hip, it might mean standing without information or climbing stairs. The facility's rehabilitation team documents your progress in writing, and Medicare uses these notes to decide whether to keep paying.

If the facility decides you no longer need inpatient rehabilitation, they must give you written notice at least two days before discharge. You have the right to appeal this decision if you believe you still need care. The notice will explain how to file an appeal and what happens if you disagree.

The difference between skilled nursing facilities and rehabilitation facilities

Medicare covers both types of facilities under the same 100-day limit per benefit period, but they serve different purposes. A skilled nursing facility (SNF) provides nursing care and therapy for people recovering from surgery, illness, or injury — for example, wound care after surgery or medication management after hospitalization. An inpatient rehabilitation facility (IRF) is more intensive and focuses on helping you regain function through several hours of therapy per day, usually for people recovering from stroke, spinal cord injury, or major orthopedic surgery.

Your doctor decides which type of facility you need based on your medical condition and how much therapy you require. Both must be Medicare-certified. If you are unsure which type of facility you are in, ask your care team — it affects how your progress is measured and what your discharge plan will look like.

What you need to know before you are discharged

As your 100 days approach or your progress plateaus, the facility will begin planning your discharge. This is also called your discharge plan. The facility must involve you and your family in this planning and provide written instructions for care at home, including any medications, exercises, or follow-up appointments you need.

If you need ongoing care after discharge — such as home health services, outpatient therapy, or care in an assisted living facility — Medicare may cover some of these services, but under different rules and limits. Home health care, for example, is covered if a doctor orders it and you are homebound, but it is not subject to the 100-day limit. Ask the facility's discharge planner what services are available in your area and whether Medicare will cover them.

If you cannot afford care after your Medicare coverage ends, ask the facility's social worker about Medicaid, local senior services, or other programs that might help. Many facilities have staff trained to connect you with these resources.

What to do if you disagree with a discharge or coverage decision

If the facility tells you that Medicare will stop paying before day 100, or if you receive a discharge notice you believe is premature, you have the right to appeal. The facility must provide you with a written notice that explains why coverage is ending and how to file an appeal.

You can appeal to may have access to Independent Contractor (QIC), an independent reviewer hired by Medicare. You must file your appeal within 120 days of receiving the notice. During the appeal process, Medicare will continue to pay for your care until a decision is made, so you will not be forced to leave while your case is under review.

To file an appeal, contact your facility's patient advocate or call Medicare directly at 1-800-MEDICARE (1-800-633-4227). Have your Medicare number and the date you received the discharge notice ready. The appeals process can take several weeks, so start as soon as you receive notice.

Frequently Asked Questions

Do I have to pay anything during my first 20 days of rehabilitation?

You pay your Part A deductible (a one-time cost per benefit period) when you enter the hospital, but once that is paid, you owe nothing for the first 20 days of rehabilitation. Starting on day 21, you owe a daily copay. If you have Medigap or Medicare Advantage, your supplemental plan may cover the deductible.

What if I need rehabilitation again within 60 days of leaving?

If you are readmitted to a hospital within 60 days of your last discharge, you stay in the same benefit period and your 100-day count continues from where it left off. For example, if you used 30 days in your first stay and are readmitted 30 days later, you have 70 days remaining in that benefit period.

Does Medicare cover rehabilitation at home instead of in a facility?

Medicare covers home health services and outpatient therapy, but these are not subject to the 100-day inpatient limit. Home health requires a doctor's order and proof that you are homebound. Outpatient therapy has its own limits and copays. Ask your doctor whether home-based rehabilitation is an option for your condition.

What if the rehabilitation facility is not Medicare-certified?

Medicare will not pay for care at a facility that is not certified. Before you are admitted or transferred, ask the facility directly whether it is Medicare-certified, or call Medicare at 1-800-MEDICARE to verify. Your hospital discharge planner should only recommend certified facilities.

Can I choose to stay longer than 100 days and pay out of pocket?

Yes, but you will pay the full cost yourself after day 100. Some facilities allow this, while others do not. Discuss this with the facility's billing department and your care team before your 100 days are up so you understand the daily cost and whether the facility can accommodate you.