THE SHORT ANSWER

Medicare can cover up to 100 days of skilled nursing and rehab per benefit period — but only after a hospital stay of at least 3 inpatient days (not counting the discharge day), and only while the person needs daily skilled care. Days 1–20 are covered in full. For days 21–100, the patient pays $217 per day in 2026 unless a supplement covers it. Medicare does not pay for long-term custodial care.

"Medicare covers 100 days" is one of the most misunderstood sentences in senior care. Here's what it really means in 2026.

The three requirements

Medicare Part A covers a skilled nursing facility (SNF) stay when:

  1. There was a qualifying hospital stay — at least 3 inpatient days (not counting the discharge day). Time under observation doesn't count. The three-inpatient-day rule.
  2. Admission to the SNF happens soon after, generally within 30 days of leaving the hospital.
  3. The person needs daily skilled care — nursing or therapy that must be provided by or under the supervision of licensed professionals.

What it costs in 2026

Days in the benefit period What the patient pays
1–20 $0
21–100 $217 per day
101 and beyond All costs

The hospital stay before it carries its own Part A deductible of $1,736 per benefit period.

Why coverage often ends before day 100

Medicare pays only while daily skilled care is needed. When the facility's team decides that therapy goals are met, or that the person needs only custodial help — with bathing, dressing, eating — Medicare coverage ends, even on day 18 or day 41.

That's normal. It doesn't mean the person is ready to go home.

Your right to appeal

At least two days before Medicare-covered services end, the facility must give a written notice (the Notice of Medicare Non-Coverage). It explains how to request a fast appeal from the Quality Improvement Organization. If you believe skilled care is still needed, appeal right away.

One rule to know: Medicare can't stop coverage just because someone isn't improving. Skilled care to maintain function or slow decline can be covered.

Medicare Advantage is different

Medicare Advantage plans must cover skilled nursing, but they can require prior authorization, use their own networks, and set different copays. Some waive the three-inpatient-day rule. Check the plan's Evidence of Coverage, and ask the plan — not only the facility — what's approved.

When Medicare stops: what's next

  • Home, with services — home health, outpatient therapy, home care. How to pay for home care.
  • Assisted living or an adult home — if the person can't safely live alone but doesn't need nursing care.
  • Long-term nursing home care — paid privately (about $13,765 a month in Western New York, the NYS DOH 2026 Western-region average private-pay rate), by long-term care insurance, or by Medicaid. What happens after day 100.

Questions families ask

Does Medicare always pay for 100 days?

No. 100 days is the maximum. Coverage ends when daily skilled care is no longer needed, which is often sooner.

Can Medicare stop because my parent isn't improving?

Not for that reason alone. Under the Jimmo settlement, Medicare covers skilled care needed to maintain function or slow decline, not only to improve.

Does Medigap cover the daily copay?

Most Medigap plans cover the skilled nursing copay in full. Plans A and B do not, and Plans K and L cover part of it.

What happens when Medicare coverage ends?

The person pays privately, uses long-term care insurance, or applies for Medicaid — or moves to a different setting such as home with services or assisted living.

Keep exploring

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