Medicare Part A will pay for up to 100 days of rehab in a skilled nursing facility (SNF) per benefit period after a hospital stay, but only the first 20 days are fully covered. Days 21 through 100 carry a daily coinsurance of $217 in 2026, and after day 100 Medicare pays nothing.1Centers for Medicare & Medicaid Services. Medicare Deductible, Coinsurance and Premium Rates – CY 2026 Update How long Medicare will actually pay for rehab after a hospital stay in your case depends on whether you clear a few specific hurdles at admission, during the hospital stay, and after transfer.
What You Have to Meet to Get SNF Coverage
Three conditions have to line up before Part A pays anything toward a SNF stay.
You need a qualifying inpatient hospital stay of at least three consecutive days. The clock starts the day you’re formally admitted as an inpatient and does not include the day you’re discharged. You then have to transfer to a Medicare-certified SNF within 30 days of leaving the hospital. And a doctor has to certify that you need daily skilled nursing or skilled therapy for a condition related to the hospital stay.2Medicare.gov. Skilled Nursing Facility Care
“Skilled” is the operative word. The services have to require a licensed nurse or therapist to perform or supervise them. Help with bathing, dressing, or eating on its own is custodial care, and Part A does not cover it.2Medicare.gov. Skilled Nursing Facility Care
The Observation Status Problem
This is where coverage most often falls apart. You can spend three nights in a hospital bed, in a hospital gown, being treated by hospital staff, and still not qualify, because the hospital classified you as an outpatient under observation rather than as an inpatient. Observation hours do not count toward the three-day inpatient requirement, no matter how long they run.2Medicare.gov. Skilled Nursing Facility Care
Hospitals must give you a written Medicare Outpatient Observation Notice (MOON) no later than 36 hours after observation services begin, if those services run past 24 hours.3Centers for Medicare & Medicaid Services. Medicare Outpatient Observation Notice (MOON) Instructions Ask directly whether you’re being admitted as an inpatient. If you’re not, ask whether your status can be changed.
Since February 2025, patients whose status was switched from inpatient to outpatient observation during a hospital visit can file a fast appeal with their state’s Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO). You can file while still in the hospital or after discharge, and the BFCC-QIO typically issues a decision about two days after the appeal is filed. If the appeal succeeds, Part A may cover both the hospital stay and the SNF care that follows.4Medicare.gov. Appeal When a Hospital Changes Your Status From Inpatient to Outpatient Getting Observation Services
What Rehab Actually Costs You in 2026
Medicare measures your SNF coverage in benefit periods. A benefit period begins the day you’re admitted as an inpatient to a hospital or SNF and ends after you’ve gone 60 consecutive days without any inpatient hospital or SNF care. There’s no lifetime cap on how many benefit periods you can have.5Medicare.gov. Inpatient Hospital Care Coverage
Within each benefit period, the 2026 numbers work like this:
- Days 1–20: $0 per day, after you’ve paid the Part A inpatient hospital deductible of $1,736 for the benefit period.
- Days 21–100: $217 per day coinsurance.
- After day 100: You pay the full cost.
Using every coinsurance day puts you at $17,360 out of pocket for days 21 through 100, on top of the $1,736 deductible.1Centers for Medicare & Medicaid Services. Medicare Deductible, Coinsurance and Premium Rates – CY 2026 Update
How Medigap and Medicare Advantage Change the Math
If you have Original Medicare plus a Medigap policy, standardized plans C, D, F, G, M, and N cover 100% of the SNF coinsurance for days 21 through 100. Plans K and L cover 50% and 75%, respectively. Plans A and B do not cover it at all. Plans C and F are closed to anyone who became newly eligible for Medicare after 2019.
Medicare Advantage plans set their own cost-sharing and often require prior authorization, so your Evidence of Coverage document controls what you pay. One tradeoff can work in your favor: most MA plans are permitted to waive the three-day inpatient hospital stay requirement, and most do.6Medicare.gov. Understanding Medicare Advantage Plans Network rules and authorization requirements may still apply, so call the plan before you transfer.
Getting a Fresh 100 Days, and the 30-Day Return Rule
Two timing rules can extend your coverage well beyond a single 100-day run.
Once you’ve gone 60 consecutive days without any inpatient hospital or SNF care, the benefit period ends. The next admission starts a new benefit period with a fresh 100 days of SNF coverage, though you’ll owe a new Part A deductible.7CMS: Medicare Benefit Policy Manual. Chapter 3 – Duration of Covered Inpatient Services
If you leave a SNF and have to return within 30 days, you don’t need another three-day qualifying hospital stay. The same rule applies if you stop receiving skilled care while in the SNF and resume it within 30 days. Your day count picks up where it left off, so 15 days used before leaving means 85 days remaining on return.2Medicare.gov. Skilled Nursing Facility Care
“You’ve Plateaued” Is Not a Valid Reason to Cut You Off
A common reason people lose SNF coverage early is the mistaken belief that Medicare only pays for rehab when you’re improving. Under the Jimmo v. Sebelius settlement, Medicare explicitly recognizes that skilled care may be necessary to prevent or slow deterioration and to maintain you at the highest practicable level of function, even when improvement isn’t expected.8Centers for Medicare & Medicaid Services. Jimmo v. Sebelius Settlement Agreement Fact Sheet
The test is whether the care requires a licensed nurse or therapist, not whether you’re making measurable progress. A therapist designing and adjusting a maintenance program after a stroke is skilled care. An aide walking you down the hall using an already-established routine is not. If a facility says Medicare is cutting off coverage because you’ve plateaued, that can be grounds for an appeal.8Centers for Medicare & Medicaid Services. Jimmo v. Sebelius Settlement Agreement Fact Sheet
Appealing an Early Discharge
When a SNF decides your Medicare-covered stay is ending, it must give you a written Notice of Medicare Non-Coverage at least two days before covered services stop.9Centers for Medicare & Medicaid Services. Notice of Medicare Non-Coverage (NOMNC) Instructions That notice triggers your right to a fast appeal through the BFCC-QIO listed on the notice. File no later than noon the day before the termination date. The BFCC-QIO usually issues a decision by the close of business the day after receiving what it needs, and if it agrees you still need skilled care, Medicare keeps paying.10Medicare.gov. Fast Appeals
The deadline is tight, but the process costs nothing. If the facility is applying an improvement standard that ignores the maintenance rules, or if you believe you still need skilled care, file.
What Happens When Medicare Stops Paying
Coverage ends at day 100, or sooner if you no longer need daily skilled care. Semi-private SNF rooms average roughly $300 per day nationally, so even a few weeks of private-pay care hits hard. The main options at that point:
- Medicaid may cover ongoing nursing facility care if your income and assets are low enough under your state’s rules. Many people need to spend down assets to qualify.
- Long-term care insurance may cover SNF costs Medicare won’t, if you bought a policy before needing care.
- VA benefits may cover nursing home care for eligible veterans, depending on service and disability history.
- Private pay covers the gap otherwise.
If SNF Isn’t the Right Setting
Rehab after a hospital stay doesn’t only happen in a SNF, and the 100-day count applies specifically to SNF care. Inpatient rehabilitation facilities provide more intensive programs for conditions like stroke, spinal cord injury, and major trauma; qualifying generally requires being able to tolerate about three hours of therapy per day, five days a week, or 15 hours within a seven-day period.11Centers for Medicare & Medicaid Services. Inpatient Rehabilitation Facility Classification Requirements Home health services can cover part-time or intermittent skilled nursing and therapy if you’re homebound and a provider certifies the plan of care.12Medicare.gov. Home Health Services Outpatient physical, occupational, and speech therapy are covered under Part B with no three-day hospital stay requirement, at the standard 20% Part B coinsurance after the deductible.13Medicare.gov. Physical Therapy Coverage