Medicare covers up to 100 days of inpatient rehabilitation per benefit period, but the number of days you actually receive depends on medical necessity and your specific situation.

When you leave a hospital after a may have access to stay and move to a skilled nursing facility (SNF) for rehabilitation, Medicare Part A pays for your care during that time. However, the coverage is not automatic for all 100 days — your doctor must document that you need daily skilled nursing or therapy, and Medicare must agree that your condition requires it.

The 100-day limit resets each time you start a new benefit period. A benefit period begins the day you enter a hospital and ends 60 days after you leave the hospital or SNF, whichever comes last. If you are readmitted to a hospital after that 60-day window closes, a new benefit period starts, and your day count resets to 100.

Key Takeaways

  • Medicare Part A covers up to 100 days in a skilled nursing facility per benefit period if you meet the three-day hospital stay requirement and your condition requires daily skilled care.
  • You pay nothing for days 1–20, a daily copay (currently $200 per day, though this amount changes yearly) for days 21–100, and all costs after day 100.
  • A new benefit period begins when you are readmitted to a hospital, which resets your 100-day count even if you used days in a previous stay.
  • Medicare stops paying when your doctor determines you no longer need daily skilled nursing or therapy, even if you have days remaining.
  • Rehabilitation at home (outpatient therapy or home health) has different coverage rules and is not subject to the 100-day limit.

What qualifies as a covered rehabilitation stay

To have Medicare pay for inpatient rehabilitation, you must first spend at least three consecutive days in a hospital (not counting the day you are discharged). This three-day requirement is strict — partial days do not count, and observation status does not count as an inpatient day, even if you stayed overnight.

After those three hospital days, you must be admitted to a skilled nursing facility within 30 days. The SNF must be Medicare-certified, and your doctor must order skilled nursing care or physical, occupational, or speech therapy that requires a facility setting. Custodial care — help with bathing, dressing, or meals alone — does not may have access to.

The condition you are being treated for in the hospital must be the same condition (or a related one) that requires skilled care at the SNF. For example, if you are hospitalized for pneumonia and then admitted to an SNF for physical therapy after a fall during that hospitalization, both are considered part of the same episode of care.

How your out-of-pocket costs work across the 100 days

Your costs change depending on which days you use. Days 1 through 20 are fully covered by Medicare Part A — you pay nothing. Starting on day 21, you owe a daily copay. This copay amount changes each year; you can find the current year's amount on Medicare.gov or by calling 1-800-MEDICARE.

After day 100, Medicare stops paying entirely, and you are responsible for all costs. This is why it matters whether your stay is medically necessary for the full time — if your doctor determines you can be discharged after 45 days, your coverage ends then, even though you have 55 days remaining.

If you have a Medigap or Medicare Advantage plan, it may cover some or all of your copays. Check your plan documents or call your plan to understand what your SNF stay will cost you out of pocket.

When Medicare stops paying before day 100

The most common reason coverage ends early is that your condition improves enough that you no longer need daily skilled care. Your doctor and the SNF team review your progress regularly. If they determine you can manage at home with outpatient therapy or family support, Medicare will stop paying even if you have days left.

You will receive written notice before your coverage ends — usually at least two days in advance. This notice, called a Notice of Non-Coverage, explains why Medicare believes you no longer need inpatient care and tells you how to appeal if you disagree. You have the right to request a peer-to-peer review, where your doctor can speak directly with a Medicare physician reviewer about whether the discharge decision is appropriate.

If you do not agree with the decision and want to stay, you can appeal, but you may be responsible for the cost of care while your appeal is being reviewed. Many people choose to leave rather than risk a large bill.

Benefit periods and how they reset your day count

Understanding benefit periods is crucial because it determines whether you get a fresh 100 days or continue counting from where you left off. A benefit period starts the day you enter a hospital as an inpatient and ends 60 days after you leave the hospital or SNF, whichever is later.

If you are discharged from an SNF on day 30 of your stay, your benefit period does not end until 60 days after that discharge. If you are readmitted to a hospital during those 60 days, you are still in the same benefit period, and any new SNF stay counts against your remaining days from the original 100.

However, if you are readmitted to a hospital after the 60-day window closes, a brand new benefit period begins. Your day count resets to 100, and you start over. This is why the timing of readmission matters — being admitted just after the 60-day window closes gives you a full new set of covered days.

Rehabilitation at home instead of a facility

If you need therapy but not inpatient skilled nursing care, Medicare may cover home health services or outpatient rehabilitation instead. Home health has different rules: there is no 100-day limit, but you must be homebound (unable to leave home without considerable effort), and a doctor must order the services.

Outpatient therapy — physical therapy, occupational therapy, or speech therapy at a clinic or hospital — is also covered under Medicare Part B, but it has an annual limit on the amount Medicare will pay, not a day limit. The limit changes yearly and applies to each type of therapy separately.

If you are unsure whether inpatient SNF care or home-based rehabilitation is right for your situation, your hospital discharge planner can help explain the options and what each would cost you.

What to do if you run out of covered days

If you reach day 100 and still need care, you have several options. You can pay out of pocket if you have the resources. You can explore whether Medicaid covers long-term care in your state — Medicaid rules vary widely, but some states cover SNF care after Medicare days run out. You can also ask the SNF about their financial information programs or whether they offer discounted rates for self-pay patients.

Some people transition to a lower level of care, such as assisted living or a residential care home, which may be less expensive than a skilled nursing facility. Your social worker or discharge planner can discuss these alternatives with you and help you understand the costs and what services each setting provides.

If you believe Medicare made an error in ending your coverage, you can appeal. The appeal process takes time, so it is important to start it quickly if you disagree with the decision to stop paying.

Frequently Asked Questions

Do I get 100 new days if I go home for a week and come back to the SNF?

No. If you are discharged from the SNF and readmitted within the same benefit period (within 60 days of your original discharge), the days count toward your original 100. You only get a fresh 100 days if you are readmitted to a hospital after the 60-day window closes, which starts a new benefit period.

What if my doctor says I can go home but I do not feel ready?

You can request a peer-to-peer review, where your doctor speaks with a Medicare physician about whether discharge is medically appropriate. You can also ask for a second opinion from another doctor at the facility. However, if Medicare and your doctors agree you do not need inpatient care, staying longer will be at your own cost.

Does Medicare cover rehabilitation in a hospital-based rehabilitation unit differently than a skilled nursing facility?

No. Both are covered under the same 100-day limit per benefit period, as long as you meet the three-day hospital stay requirement. The main difference is the level of intensity — hospital-based rehab units typically provide more hours of therapy per day, but the Medicare coverage rules are the same.

Can I use my remaining days at a different facility if I want to transfer?

Yes. If you have days remaining and your doctor agrees a transfer is medically appropriate, you can move to another Medicare-certified SNF. Your remaining days follow you — they do not reset. However, the new facility must accept Medicare, and your doctor must order continued skilled care.

What happens to my days if I am hospitalized again while in the SNF?

If you are readmitted to a hospital from the SNF, your SNF days pause. When you return to the SNF (or a different one), you resume counting from where you left off within the same benefit period. The hospital stay itself does not use up your SNF days.