How Long Medicare Covers Your Stay in a Skilled Nursing Facility

Medicare covers up to 100 days in a skilled nursing facility per benefit period, but you pay nothing for days 1–20 and a daily copay for days 21–100

Medicare Part A pays for skilled nursing facility (SNF) care after a hospital stay, but the number of days covered and what you pay depends on how long you stay. You get the first 20 days fully covered at no cost to you. From day 21 through day 100, Medicare pays most of the cost, but you pay a copay each day — this amount changes yearly and was $194.50 per day in 2024. After day 100 in the same benefit period, Medicare stops paying and you are responsible for all costs.

A benefit period starts the day you enter the hospital and ends 60 days after you leave the SNF with no readmission. If you go back to the hospital and then return to a SNF, a new benefit period begins, and your day count resets to 1.

Key Takeaways

Medicare Part A covers up to 100 days in a skilled nursing facility per benefit period, with no cost for days 1–20 and a daily copay for days 21–100.
You must have been admitted to a hospital for at least three consecutive days before Medicare will pay for SNF care.
Your benefit period resets if you are discharged from the SNF for 60 or more consecutive days and then readmitted, or if you are readmitted after a new hospital stay.
If you have Medigap or Medicare Advantage coverage, your out-of-pocket costs for days 21–100 may be lower than the standard copay amount.
The SNF must be Medicare-certified and your doctor must order skilled care — custodial care alone does not may have access to.

What counts as a three-day hospital stay

Before Medicare will pay for any SNF care, you must have spent at least three consecutive days in a hospital as an inpatient. The three days are counted from midnight of your admission day through midnight of your discharge day. If you are admitted on a Monday and discharged on Wednesday, that counts as three days.

Time spent in the emergency department, observation status, or outpatient surgery does not count toward the three-day requirement, even if you stayed overnight. You must be admitted as an inpatient — your hospital bill should say "inpatient" or "Part A," not "observation" or "outpatient." If you are unsure whether your hospital stay may have access to, ask the hospital billing department or call Medicare at 1-800-MEDICARE.

How the 100-day limit works across benefit periods

Your 100 days of SNF coverage are tied to a benefit period, not a calendar year. A benefit period begins the day you are admitted to the hospital and ends 60 days after you leave the SNF without being readmitted. If you are readmitted to a SNF within 60 days of leaving, you continue using the same benefit period and the same day count — you do not get a fresh 100 days.

If you leave the SNF and stay out for 60 or more consecutive days, your benefit period ends and a new one begins if you are readmitted. A new benefit period also starts if you are readmitted to a hospital and then sent to a SNF again. When a new benefit period starts, your day count resets to 1, and you get another 100 days of coverage.

For example: You are hospitalized, then admitted to a SNF on January 10 and discharged on January 25 (15 days used). You are readmitted to the SNF on February 5 (within 60 days). You are still in the same benefit period and have 85 days remaining. If instead you were readmitted on March 15 (more than 60 days later), a new benefit period would begin and you would have 100 days available again.

What you pay on days 21 through 100

On days 1 through 20, Medicare Part A covers the full cost of your SNF care and you pay nothing. Starting on day 21, you pay a daily copay amount, and Medicare covers the rest. In 2024, this copay was $194.50 per day. The amount increases each year and is set by Medicare in the fall for the following year.

This copay covers your room, meals, nursing care, therapy, and most medications given in the facility. It does not cover private room upgrades, phone, television, or personal care items you choose to purchase. Some SNFs may charge extra for these items, and you are responsible for those costs in addition to the daily copay.

If you have a Medigap (supplemental insurance) policy, it may cover some or all of the daily copay for days 21–100. If you have Medicare Advantage, your copay may be different from the standard amount — check your plan documents or call your plan. If you have neither, you will owe the full daily copay amount for each day from day 21 onward.

When Medicare stops paying after day 100

Once you reach day 100 in a benefit period, Medicare Part A stops paying for SNF care. You become responsible for the full daily cost of the facility, which can range from $200 to $400 or more per day depending on the facility and your location. This is why it is important to understand your benefit period and plan ahead if you think you may need more than 100 days.

If you cannot afford to pay out of pocket, talk to the SNF social worker about options. Some facilities offer payment plans, and you may be able to transition to a lower level of care (such as assisted living or home care) that costs less. Medicaid may also cover SNF care if you meet income and asset limits, though rules vary by state.

Requirements for Medicare to cover SNF care

Not all nursing home stays are covered by Medicare. The facility must be Medicare-certified, and your doctor must order skilled nursing care — not just custodial care. Skilled care includes services like wound care, medication management, physical therapy, occupational therapy, or speech therapy that require a nurse or therapist to perform.

Custodial care — help with bathing, dressing, eating, or toileting — is not covered by Medicare, even if a nurse provides it. If you need only custodial care, Medicare will not pay, and you will need to pay out of pocket or use Medicaid if you may have access to. The SNF must also admit you within 30 days of leaving the hospital for Medicare to cover the stay.

Before you are discharged from the hospital, ask your doctor whether the SNF care you need qualifies as skilled care. If you are unsure after admission to the SNF, ask the facility's care coordinator or call Medicare to confirm your stay is covered.

What to ask your doctor and the SNF

Before you leave the hospital, ask your doctor: "Will I need skilled nursing care, and for how long?" and "Which SNFs accept Medicare?" Ask the SNF: "Is this facility Medicare-certified?" and "How many days do you expect I will need to stay here?" Ask the SNF to explain your costs for days 1–20 and days 21–100, and whether your copay will change if your length of stay extends beyond your initial estimate.

Request a written summary of your Medicare coverage and what you will owe. If you have supplemental insurance or Medicare Advantage, bring your insurance card and ask the SNF to verify your coverage before you are admitted. Ask the SNF social worker about your options if you reach day 100 and still need care.

Frequently Asked Questions

What happens if I need more than 100 days of care?

After day 100, Medicare stops paying and you are responsible for all costs. You can pay out of pocket, explore for Medicaid if you meet income limits, or transition to a lower level of care such as assisted living or home health. Some facilities offer payment plans or sliding-scale fees based on income.

Does my hospital stay have to be three days long, or just three days in the hospital?

You must be admitted as an inpatient for at least three consecutive calendar days. Time in the emergency department or observation status does not count. Ask the hospital to confirm your admission was inpatient status, not observation.

If I go home and then come back to the SNF within 60 days, do I lose my remaining days?

No. If you are discharged from the SNF and readmitted within 60 days, you stay in the same benefit period and keep your remaining days. Your day count continues where it left off. If you stay out for 60 or more days, a new benefit period begins and you get 100 days again.

Does Medicare Advantage cover SNF care the same way as Original Medicare?

Medicare Advantage plans must cover at least the same number of days as Original Medicare (up to 100 per benefit period), but your copay amounts and other rules may differ. Check your plan documents or call your plan to learn your specific copay for days 21–100.

Can I choose any nursing home, or does it have to be Medicare-certified?

The facility must be Medicare-certified for Medicare to pay. You can search for certified facilities on Medicare.gov or ask your hospital discharge planner for a list of options in your area.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.