Yes, Medicare can cover a short stay in a skilled nursing facility for rehab or nursing care, for up to 100 days. But coverage depends on a few specific rules. Here is how it works in 2026, in plain language.
Quick takeaways
- Medicare Part A can cover up to 100 days of skilled nursing or rehab per benefit period, but only after a qualifying inpatient hospital stay of at least three days.
- Time spent “under observation” in the hospital does not count toward the three days, even if you stayed overnight.
- Medicare does not pay for long-term custodial care, such as help with bathing and dressing on its own.
What Medicare covers in a skilled nursing facility
Original Medicare Part A helps pay for a stay in a Medicare-certified skilled nursing facility (SNF) when you need daily skilled care that can only be given by licensed nurses or therapists. That usually includes:
- A semi-private room and meals
- Skilled nursing care, such as wound care, IV medications and monitoring
- Physical, occupational and speech therapy
- Medications, medical supplies and equipment used during the stay
- Social services and dietary counseling
This is the kind of short-term stay many people know as “rehab” after a hospital visit. If you are not sure how it differs from other levels of care, our guide to subacute rehab explains it step by step.
Who qualifies: the rules to know
Under Original Medicare, all of these generally need to be true:
- You had a qualifying hospital stay. This means at least three days in a row as a formally admitted inpatient (more on this below).
- Your doctor says you need daily skilled care. The care must be something only licensed nurses or therapists can safely provide.
- You enter the facility soon after the hospital. Usually within 30 days of leaving, for a condition that was treated in the hospital or that started while you were in skilled care.
- The facility is Medicare-certified. Most skilled nursing facilities are, but it is always worth asking.
One common myth is that Medicare only pays while you are improving. That is not the rule. Coverage depends on whether you need skilled care, which can include care to maintain your condition or slow a decline.
The Medicare 3-day rule and observation status
The three-day rule trips up more families than anything else. Only days you spend as a formally admitted inpatient count. Time in the emergency room, and time spent “under observation,” does not, even if you stayed overnight in a regular hospital bed. The day you leave the hospital does not count either.
That is why it matters to ask, early and in writing: “Is my loved one an inpatient, or here under observation?” If the answer is observation, ask the doctor or case manager whether inpatient admission is appropriate, and how a later rehab stay would be paid for.
The most important question to ask in the hospital is simple: “Is this an inpatient admission or observation status?”
How long Medicare coverage lasts
Medicare can cover up to 100 days of skilled nursing care in each benefit period.
Keep in mind that 100 days is a maximum, not a set length. Coverage continues as long as you still need daily skilled care, and most short-term rehab stays are much shorter than 100 days. Our admissions team can walk you through exactly what your coverage includes before admission, so there are no surprises.
How the Medicare benefit period works
A benefit period starts the day you are admitted to a hospital or skilled nursing facility. It ends once you have gone 60 days in a row without inpatient hospital or skilled nursing care. A new benefit period can bring a new set of covered days, but you would generally need another qualifying hospital stay.
Medicare Advantage and other coverage
Medicare Advantage plans must cover skilled nursing care, but their rules can differ from Original Medicare. Some plans waive the three-day hospital stay, many require approval before admission, and most have their own network of facilities. Call the plan before discharge to confirm what is covered and where.
Part B can help pay for outpatient physical, occupational and speech therapy after you go home.
What Medicare does not cover
Medicare does not pay for long-term custodial care when that is the only help someone needs. Custodial care means help with everyday activities like bathing, dressing, eating and getting around. If a loved one is likely to need care for months or years, read our guides to what long-term care involves and how families pay for it. In Maryland, many people eventually rely on Medicaid to cover nursing home care.
If Medicare coverage is ending: your right to appeal
When the facility believes Medicare will stop covering your care, you should receive a written notice called a Notice of Medicare Non-Coverage, usually at least two days before covered services end. If you disagree, you can ask for a fast appeal. The notice explains how, including who to call and the deadline. Acting quickly matters, because deadlines are short.
Questions to ask before hospital discharge
- Is my loved one an inpatient or under observation, and for how many days?
- Does the doctor expect a need for daily skilled nursing or therapy?
- Is the recommended facility Medicare-certified, and in network for our plan?
- Does our Medicare Advantage plan require approval first?
Free, unbiased Medicare counseling is also available through Maryland’s State Health Insurance Assistance Program (SHIP).
Frequently asked questions
Does Medicare pay for nursing home care?
Medicare pays for short-term skilled nursing and rehab in a nursing facility when the rules are met, for up to 100 days per benefit period. It does not pay for long-term custodial care when that is the only care a person needs.
What is the Medicare 3-day rule?
To qualify for skilled nursing coverage under Original Medicare, you need an inpatient hospital stay of at least three consecutive days, not counting the day you leave. Days spent under observation or in the emergency room before admission do not count.
How long does Medicare cover skilled nursing?
Medicare can cover up to 100 days of skilled nursing care per benefit period, as long as you meet the rules and still need daily skilled care.
What happens after 100 days of Medicare in a nursing home?
Medicare coverage for that benefit period ends. Families then look at other options, such as long-term care insurance or Medicaid for people who qualify. Our admissions team can talk through what fits your situation.
Does Medicare Part B cover physical therapy?
Yes. Part B can help pay for outpatient physical, occupational and speech therapy that is medically necessary, such as therapy after you return home from a rehab stay.
This article is general information, not medical, legal or financial advice. Coverage rules can change, so confirm details with Medicare, your plan or your care team.
