Skilled nursing under Medicare: the 3-day rule, 100 days, and what it really costs
How Medicare covers skilled nursing facility care, the qualifying stay rule, the $217-a-day coinsurance from day 21, and why most stays end before day 100.
After a hospital stay, many people need short-term rehab in a skilled nursing facility (SNF). Original Medicare covers it, but only under specific conditions and only partly.
The conditions
- A qualifying inpatient hospital stay of at least three days (observation days do not count; see observation vs inpatient).
- Admission to a Medicare-certified SNF, usually within 30 days of discharge.
- A doctor certifies that you need daily skilled care, such as physical therapy or wound care, related to the hospital condition.
What you pay in 2026
- Days 1–20: $0.
- Days 21–100: $217.00 a day.
- After day 100: all costs.
A full 100-day stay would cost $17,360 in coinsurance alone.
Why most stays end early
Coverage continues only while you need and benefit from skilled care. When you plateau or need only custodial help (bathing, dressing, eating), Medicare coverage ends, even if day 100 is far away. You should receive a written notice before coverage ends and can request a fast appeal.
Medigap and skilled nursing
Plans C, D, F, G, M and N pay the full day 21–100 coinsurance; K pays 50% and L pays 75%. Plans A and B do not cover it.
Medicare Advantage
Many Medicare Advantage plans waive the 3-day rule but require prior authorization and use their own daily copays. Check the plan's Evidence of Coverage.
Long-term care is different
Neither Medicare nor Medigap pays for long-term custodial care in a nursing home. That is a long-term care insurance or Medicaid question.
Questions people ask
How many days of skilled nursing does Medicare cover?
Up to 100 days per benefit period, with coinsurance from day 21.
What is the 2026 SNF coinsurance?
$217.00 a day for days 21 to 100.
Does Medicare pay for long-term nursing home care?
No, only short-term skilled care.
Which Medigap plans cover SNF coinsurance?
C, D, F, G, M and N fully; K at 50% and L at 75%.
Independent educational site. Not affiliated with or endorsed by the U.S. government, the federal Medicare program, or any insurance company. Figures are 2026 amounts published by CMS unless noted; check Medicare.gov for your situation.