Does Medicare Cover Skilled Nursing Facility Care?

The Short Answer: Yes, With Conditions

Medicare Part A covers skilled nursing facility (SNF) care, but only when you meet specific requirements. Many people assume Medicare pays for ongoing nursing home stays. It does not. Medicare covers skilled care after a qualifying hospital stay, for a limited time, and only in Medicare-certified facilities. Understanding these boundaries before you or a family member needs SNF care can prevent a very large unexpected bill.

As of 2026, Medicare covers up to 100 days of SNF care per benefit period under Part A. After day 100, Medicare pays nothing, and you become responsible for the full daily cost, unless you have additional coverage such as a Medigap plan or Medicaid. For a broader look at what Medicare Part A coverage includes, see our full guide.

What Is a Skilled Nursing Facility?

A skilled nursing facility is a licensed, Medicare-certified care center that provides medically necessary services you cannot safely receive at home. The word 'skilled' is the key to understanding Medicare's rules: Medicare pays only when a licensed professional, a registered nurse, a physical therapist, or a speech-language pathologist, must provide or closely supervise your care.

Examples of skilled care Medicare will cover in an SNF include:

• Wound care following surgery or injury
• Intravenous (IV) medications that require nursing oversight
• Physical therapy to regain mobility after a stroke or hip replacement
• Occupational therapy to relearn daily tasks
• Speech-language therapy following a neurological event

Custodial care, help with bathing, dressing, eating, or moving around, does not qualify as skilled care. Medicare does not cover long-term custodial care, regardless of how much you need it. If the only services you need are custodial, Medicare will not pay for your SNF stay, even in a Medicare-certified facility.

The Three-Day Hospital Stay Requirement

Before Medicare will pay for any SNF care, you must have a qualifying inpatient hospital stay of at least three consecutive days, not counting the day you are discharged. This requirement is commonly called the 'three-day rule.'

Several important details apply:

• Observation status does not count. If you spent nights in the hospital but were classified as an outpatient under 'observation status' rather than formally admitted as an inpatient, those days do not count toward the three-day requirement. Hospitals are required to give you a written Medicare Outpatient Observation Notice (MOON) if you are placed on observation status for more than 24 hours.
• You must be admitted to the SNF within 30 days of your hospital discharge.
• The SNF stay must address a condition related to the qualifying hospital stay.

If you are uncertain whether your hospital stay counted as inpatient, ask the hospital's billing department or a patient advocate before discharge. This distinction can determine whether Medicare covers thousands of dollars in SNF costs.

How Medicare Pays for Skilled Nursing Facility Care

Medicare Part A uses a benefit period structure. A benefit period begins the day you are admitted to a hospital or SNF and ends when you have been out of both settings for 60 consecutive days. You can have more than one benefit period in a year, which means your SNF coverage can reset.

Within each benefit period, coverage works as follows, based on Medicare.gov's official SNF coverage rules:

• Days 1-20: Medicare pays the full approved amount. You owe nothing for covered services beyond the Part A deductible, which applies to the full benefit period.
• Days 21-100: You pay a daily coinsurance. In 2025 this was $209.50 per day; the Centers for Medicare and Medicaid Services (CMS) updates this figure each year. Check CMS.gov for the current 2026 amount. Medicare pays the remainder of the approved daily rate.
• Days 101 and beyond: Medicare stops paying entirely. You are responsible for 100% of the daily facility cost.

The Part A deductible applies per benefit period, not per year. If you need SNF care in a second benefit period later in the year, you pay the deductible again. In 2025 the Part A deductible was $1,676; verify the current 2026 figure at Medicare.gov.

Medicare Advantage and Skilled Nursing Facilities

If you are enrolled in a Medicare Advantage (Part C) plan rather than Original Medicare, your SNF benefits may work differently. Plans must cover at least the same services as Original Medicare, but they can structure cost-sharing differently and usually require you to use in-network facilities.

Key differences to watch for with Medicare Advantage SNF coverage:

• Prior authorization: Many Medicare Advantage plans require written approval before a SNF stay is covered. Your doctor or the hospital typically must request this authorization while you are still hospitalized, before you transfer.
• Network restrictions: Full SNF benefits usually apply only at in-network facilities. Out-of-network SNFs may cost significantly more or not be covered at all, depending on your plan type.
• The three-day rule: Some Medicare Advantage plans have waived the three-day hospital stay requirement. Check your plan's Evidence of Coverage document to find out whether your plan offers this flexibility.
• Extended days: A small number of plans cover SNF care beyond 100 days, though cost-sharing varies.

If you are choosing between Original Medicare and a Medicare Advantage plan, SNF flexibility is worth considering carefully. Original Medicare lets you use any Medicare-certified SNF in the country without prior authorization. Our guide to Medicare Special Needs Plans covers one type of Advantage plan designed for people with complex or chronic care needs who often rely on SNF services.

How to Reduce Your SNF Out-of-Pocket Costs

The daily coinsurance for days 21-100 adds up quickly. If you remain in a SNF through day 100, your coinsurance costs alone could exceed $15,000 in a single benefit period, and you could have more than one benefit period in a year. Two coverage options can substantially reduce this exposure.

Medigap (Medicare Supplement) Plans

Medigap plans are sold by private insurers to work alongside Original Medicare. Most standardized Medigap plans cover some or all of the SNF daily coinsurance for days 21-100. Plan G, one of the most popular options, covers the coinsurance in full. Plan K and Plan L cover a portion. Our Medicare Supplement guide explains how each lettered plan compares and what to look for when choosing one.

Medicaid

If you have limited income and assets, Medicaid may cover long-term nursing facility care that Medicare does not, including custodial care and stays beyond 100 days. People who qualify for both Medicare and Medicaid, called dual eligible, typically receive the most complete SNF coverage, with Medicaid picking up cost-sharing that Medicare leaves behind. Your decisions about Medicare and Social Security benefits can also affect your income in ways relevant to Medicaid eligibility.

Employer or retiree coverage may provide additional SNF benefits if you or your spouse still have it. See how medicare and employer coverage coordinates with Part A for more detail.

When Medicare Stops Paying During Your SNF Stay

Medicare can end SNF coverage before day 100 if your condition stabilizes and you no longer need skilled care. The coverage limit is based on medical need, not on calendar days alone. When that happens, the SNF must give you a written Notice of Medicare Non-Coverage (NOMNC) at least two days before coverage ends. This notice explains the last day Medicare will pay and your right to appeal.

You have the right to a fast, free appeal through your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO). If you request the appeal by noon on the last covered day, Medicare coverage continues while the review is underway, you cannot be billed for that period. If the appeal is decided in your favor, coverage continues. If not, you become responsible for costs starting from the date coverage ended.

Medicare Advantage plan denials follow a similar appeal process through the plan itself. Your State Health Insurance Assistance Program (SHIP) offers free, unbiased help navigating SNF appeals; find your local SHIP at Medicare.gov.