Medicare Coverage for Skilled Nursing Care
Medicare covers a skilled nursing facility stay only under specific conditions: a qualifying hospital stay, skilled care ordered by a doctor, and days left in a 100-day benefit period. The family that knows the rules before discharge avoids surprise bills. This page is the rules, the costs, and the questions to ask.
know before discharge
The SNF coverage map
Medicare's coverage of skilled nursing facility care has strict conditions, and the family must ask these questions before the parent leaves the hospital, not after.
- Condition 1A qualifying hospital stayMedicare covers SNF care only after a related hospital stay of at least 3 days (midnight count). Days in observation, not admitted, do not count, so ask about admission status at the hospital.
- Condition 2A doctor's order for skilled careThe care must require skilled nursing or therapy services ordered by a doctor and provided daily.
- Condition 3Days left in the 100-day benefit periodMedicare covers up to 100 days per benefit period with a daily coinsurance after day 20; a benefit period starts with a hospital stay and ends after 60 days without inpatient care.
- Before discharge, askAdmitted or observation? Certified? For how long?Was the parent admitted or in observation, is the facility Medicare-certified, will the stay be covered and for how long (a written estimate), and what happens if Medicare stops paying, including the appeal and free SHIP counselor help.
Know before discharge: Medicare's coverage of skilled nursing facility (SNF) care has strict conditions. The Medicare.gov SNF coverage page is the authoritative checklist, and the hospital discharge guide explains why the family must ask these questions before the parent leaves the hospital, not after.
Not the page you need? This page is about what Medicare pays for a skilled nursing stay. For what the facility actually provides and the family's decision checklist, see skilled nursing, explained.
The three conditions Medicare requires
- A qualifying hospital stay. Medicare covers SNF care only after a related hospital stay of at least 3 days (midnight count), per Medicare.gov. Days in observation, not admitted, do not count, so the family should ask about admission status at the hospital.
- A doctor's order for skilled care. The care must require skilled nursing or therapy services ordered by a doctor and provided daily.
- Days left in the 100-day benefit period. Medicare covers up to 100 days per benefit period, with a daily coinsurance after day 20. A benefit period starts with a hospital stay and ends after 60 days without inpatient care.
What it costs
For days 1 to 20, Medicare pays the full covered amount. For days 21 to 100, the parent pays a daily coinsurance amount that changes each year (the family can confirm the current amount on Medicare.gov). After day 100, Medicare pays nothing for SNF care, and the paying for long-term care guide covers what comes next, including Medicaid and other options.
The questions to ask before discharge
- Was the parent admitted or in observation? Observation days do not count toward the 3-day rule.
- Is the facility Medicare-certified? Medicare only pays certified facilities; the skilled nursing facility guide covers choosing one.
- Will the stay be covered and for how long? Ask the discharge planner for a written estimate and the coverage timeline.
- What happens if Medicare stops paying? The facility must give written notice; the family should appeal if they disagree. The SHIP counselors provide free help with Medicare questions and appeals.
Related guides
Sources & verification
This page is checked against the standards in our editorial policy, preferring government sources. Reviewed August 2026:
- Medicare.gov: Skilled Nursing Facility (SNF) Care (retrieved August 2026)
Found an error? Report it: we log and correct material mistakes publicly.
Quick answers
Common questions, answered plainly. The details match the sources above.
Does Medicare pay for a nursing home stay?
Medicare covers skilled nursing facility care only under conditions: a related hospital stay of at least 3 days, a doctor's order for daily skilled care, and days remaining in the 100-day benefit period. It does not cover long-term custodial care.
How much does the family pay for SNF care under Medicare?
Medicare pays in full for the first 20 covered days, then the parent pays a daily coinsurance for days 21 to 100. After day 100 Medicare pays nothing, so the family should plan for what comes next with the discharge planner early.
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