Quick Answer
Medicare Part A covers up to 100 days in a skilled nursing facility (SNF) per benefit period - but only after a qualifying 3-day inpatient hospital stay. Days 1–20 are fully covered. Days 21–100 require a daily coinsurance payment ($217 in 2026). After day 100, Medicare pays nothing. A [Medigap plan](/faqs/what-is-a-medicare-supplement-plan-and-who-needs-one) can cover the daily coinsurance and extend your financial protection.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare (Part A) | Covered - up to 100 days/benefit period | Days 1–20 free; days 21–100 cost $217/day (2024); nothing after day 100 |
| Medicare Part B | Partial - outpatient therapy only | Covers outpatient physical, occupational, and speech therapy after SNF discharge |
| Medicare Advantage | Covered - varies by plan | Must match Original Medicare minimum; prior authorization almost always required |
| Medigap (Plan G/N) | Covered - cost-sharing | Covers Part A coinsurance for days 21–100; reduces your cost to $0 with Plan G |
Understanding Your Coverage Options
Original Medicare (Part A)
Covered - up to 100 days per benefit periodMedicare Part A is the primary payer for skilled nursing facility care. To qualify, you must have had a qualifying inpatient hospital stay of at least 3 consecutive days (not counting the discharge day). The SNF admission must occur within 30 days of your hospital discharge.
Days 1–20 are covered at 100% - you pay nothing. Days 21–100 require a daily coinsurance of $217 in 2026. After day 100, Medicare pays nothing and you are responsible for the full daily rate, which can exceed $300–$500 per day at many facilities.
Each benefit period resets when you have been out of a hospital or SNF for 60 consecutive days, meaning you can receive another 100-day benefit if you are re-hospitalized.
What It Covers
- Semi-private room and board
- Skilled nursing care (wound care, IV therapy, injections)
- Physical, occupational, and speech therapy
- Medical social services
- Medications, medical supplies, and equipment used in the facility
- Dietary counseling
What It Doesn't Cover
- Custodial care only (bathing, dressing, eating - with no skilled care)
- Private room (unless medically necessary)
- Personal items (TV, phone, toiletries)
- Care in a non-Medicare-certified facility
2024 SNF coinsurance: $0/day (Days 1–20), $217/day (Days 21–100), 100% out-of-pocket (Day 101+).
Observation Status Does not Count
The 3-day hospital stay rule is strict - observation status does not count. Always confirm with your hospital that you are admitted as an inpatient, not under observation.
Medicare Advantage
Covered - prior authorization requiredMedicare Advantage plans must cover the same SNF benefits as Original Medicare, but the cost-sharing structure can differ significantly. Some plans offer lower daily coinsurance for days 21–100, while others may extend SNF coverage beyond 100 days.
Most Advantage plans require prior authorization for SNF admission. Without prior authorization, your claim may be denied. Always contact your plan before or immediately after a SNF admission.
Network restrictions may also apply - you may need to use an in-network SNF to receive full benefits. Out-of-network SNF care may result in higher costs or no coverage at all.
Costs vary by plan. Review your plan's Evidence of Coverage (EOC) for exact SNF cost-sharing details.
Always Get Prior Authorization
Always verify prior authorization requirements with your Medicare Advantage plan before or immediately after a SNF admission. Failure to do so can result in claim denial.
Medigap (Medicare Supplement)
Covers days 21–100 coinsurance with Plan GA Medigap Plan G or Plan N will cover the daily coinsurance for SNF days 21–100, reducing your out-of-pocket cost to $0 for those days. This can save you over $16,760 if you use the full 80 days of coinsurance coverage.
Medigap does not extend the 100-day benefit period - after day 100, you are still responsible for all costs. However, for most SNF stays, the 100-day benefit is sufficient.
If you are enrolled in a Medicare Advantage plan, you cannot use a Medigap policy. Medigap only works alongside Original Medicare (Parts A and B).
What It Covers
- Part A coinsurance for SNF days 21–100 ($0/day with Plan G)
- Part A deductible (covered by Plan G)
- Excess charges (covered by Plan G)
What It Doesn't Cover
- SNF care beyond day 100
- Custodial care not covered by Medicare
With Plan G: $0 for SNF days 1–100 (after Part A deductible). Without Medigap: up to $16,760 in coinsurance for days 21–100.
SNF Daily Cost Breakdown (2024)
| Days in SNF | Medicare Pays | You Pay (No Supplement) | You Pay (With Plan G) |
|---|---|---|---|
| Days 1–20 | 100% | $0 | $0 |
| Days 21–100 | All but $217/day | $217/day | $0 |
| Day 101+ | $0 | Full daily rate | Full daily rate |
| Max 80-day coinsurance exposure | - | Up to $16,760 | $0 |
✦ When Medicare Won't Cover SNF Care
Custodial Care Only
Medicare does not cover custodial care - help with activities of daily living (bathing, dressing, eating) when no skilled nursing or therapy services are needed. If you only need custodial care, Medicare will not pay, even if you are in a SNF.
No Qualifying Hospital Stay
If you were not admitted as an inpatient for at least 3 consecutive days before your SNF admission, Medicare will not cover the SNF stay. Observation status days do not count toward the 3-day requirement.
SNF not Medicare-Certified
The skilled nursing facility must be Medicare-certified for Medicare to pay. Always confirm the facility's certification status before admission.
Improvement No Longer Expected
Medicare covers SNF care as long as you need skilled services and are making progress. If your condition plateaus and no further improvement is expected, Medicare may stop covering the stay - even before day 100.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.