Medicare Skilled Nursing Coverage: 3-Day Rule and 100-Day Limit

Medicare Part A pays for up to 100 days of skilled nursing facility care in each benefit period, after a hospital stay of at least 3 days as an inpatient. You pay nothing for days 1 to 20. For days 21 to 100, you pay a daily coinsurance amount.

Key takeaways

• You need at least 3 days in a row as a hospital inpatient. Time under observation does not count.
• Part A covers up to 100 days of skilled nursing care in each benefit period.
• Days 1 to 20 cost $0. Days 21 to 100 have a daily coinsurance set each year. After day 100, you pay all costs.
• Medicare covers skilled care, such as nursing and therapy, not long-term help with bathing or dressing alone.

What is a skilled nursing facility?

A skilled nursing facility, or SNF, is a place that gives daily nursing care or therapy after a hospital stay. Many nursing homes have a skilled nursing unit. The facility must be certified by Medicare.

Skilled care is care that only trained staff can give safely. Examples include wound care, IV medicines (medicine given through a vein), and physical, occupational or speech therapy. A doctor must order it, and you must need it daily.

Medicare pays for this care to help you recover or to keep your condition from getting worse. You do not have to be getting better for Medicare to keep paying. What matters is that you still need skilled care.

To compare facilities, use Care Compare at Medicare.gov. It shows each facility's star ratings, staffing levels and health inspection results, so you can check a facility before you choose it.

How does the 3-day hospital stay rule work?

Before Medicare pays for skilled nursing care, you need a qualifying hospital stay. That means at least 3 days in a row as an inpatient. Hospitals count this as 3 midnights after a doctor formally admits you.

The day you leave the hospital does not count. Time in the emergency room does not count. Time under observation does not count either, even if you stay overnight in a regular room.

Observation is outpatient care while doctors decide whether to admit you. Ask the hospital staff each day whether you are an inpatient or under observation. Our guide to hospital observation vs. admission explains why it matters for your bill.

You usually must enter the skilled nursing facility within 30 days of leaving the hospital. The care must be for the condition treated in the hospital, or one that started while you were in the facility.

What do you pay each day?

Your cost depends on how many days you have used in the current benefit period.

The table shows the turning points: day 21 and day 101. Medicare publishes the daily coinsurance for each year on Medicare.gov. The amount is the same in every Medicare-certified facility.

The hospital stay that qualifies you has its own cost. In 2026, the Part A inpatient hospital deductible is $1,736 per benefit period; it is set each year. You pay it once per benefit period, and the skilled nursing days that follow are in that same benefit period.

How does a benefit period reset?

A benefit period starts the day you are admitted to a hospital as an inpatient. It ends after you go 60 days in a row without inpatient hospital or skilled nursing care.

When a new benefit period starts, your 100 days start over. You also need a new 3-day inpatient stay before Medicare pays for skilled nursing care again. And you pay the Part A deductible again.

There is no limit on the number of benefit periods you can have. If you leave the facility and return within 30 days for the same condition, you may not need a new hospital stay.

What does Medicare not pay for?

Medicare does not pay for custodial care alone. Custodial care is help with daily tasks, such as bathing, dressing, eating or using the bathroom. Long-term nursing home stays are mostly custodial care.

If you need that kind of help for a long time, you pay for it yourself unless other coverage helps. Medicaid (a joint federal and state program for people with limited income and resources) pays for long-term nursing home care for people who qualify. Long-term care insurance may also help. Learn more in What Medicare Doesn't Cover.

Medicare also does not pay for a private room unless it is medically needed. Personal items, such as a phone or TV in your room, are not covered either.

What if the facility says coverage is ending?

If the facility decides Medicare will stop paying, it must give you a written notice. This is called a Notice of Medicare Non-Coverage. You should get it at least 2 days before your covered services end.

You can ask for a fast appeal. The notice tells you how to contact the group that reviews these cases. You must ask by noon of the day before your services end.

While the appeal is reviewed, you usually do not pay for the care, except any daily coinsurance. If the appeal is denied, you may have to pay from the date coverage ended.

Sometimes a facility thinks Medicare will not pay for a service before you get it. Then it may give you a Skilled Nursing Facility Advance Beneficiary Notice. That notice explains the expected cost and lets you decide whether to get the care.

How do Medigap and Medicare Advantage work here?

Many Medigap policies (private insurance that helps pay Original Medicare's costs) help pay the daily coinsurance for days 21 to 100. How much each policy pays depends on the plan letter.

Medicare Advantage plans must cover skilled nursing care, but their rules and costs differ. Some plans do not require a 3-day hospital stay. Many require approval before you enter the facility. Costs, networks and rules vary by plan, location and carrier.

When you leave the facility, you may still need some skilled care. Medicare may pay for part-time care at home. See Medicare Home Health Care to learn when it applies.

Have questions? Call 1-877-443-3251 to talk it through with a licensed insurance agent. You never pay the agent; the plans they represent do, and the decision stays yours.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information.