How Long Will Medicare Pay for a Rehab Facility?

Medicare provides coverage for rehabilitation facility stays through Medicare Part A. These “rehab facilities” often refer to Skilled Nursing Facilities (SNFs) that offer specific care after a hospital stay. Medicare Part A covers medically necessary skilled nursing care and rehabilitation services for a limited period after an inpatient hospital admission.

Medicare’s Criteria for Coverage

Medicare covers a Skilled Nursing Facility (SNF) stay if several requirements are met. A prior inpatient hospital stay is necessary, meaning a beneficiary must have been admitted as an inpatient for at least three consecutive days. Time spent under observation status or in the emergency room does not count toward this three-day inpatient requirement. The admission day is counted, but the discharge day is not.

Once discharged from the hospital, admission to the Medicare-certified SNF must occur within 30 days. The patient must require and receive daily skilled nursing care or skilled therapy services, such as physical therapy, occupational therapy, or speech-language pathology. These services must be so complex that they can only be safely and effectively performed by, or under the supervision of, professional skilled personnel. A physician must certify the ongoing need for these skilled services.

Skilled care differs from custodial care, which involves assistance with daily living activities like bathing, dressing, or eating. Medicare Part A does not cover custodial care if that is the only type of care needed. Skilled services are intended to treat an injury or illness, help with recovery, or maintain a condition to prevent decline.

Duration of Covered Stays

Medicare Part A coverage for Skilled Nursing Facility (SNF) stays is measured in “benefit periods.” A benefit period begins the day a beneficiary is admitted as an inpatient to a hospital or SNF. This period ends when the beneficiary has not received inpatient hospital care or skilled care in an SNF for 60 consecutive days. There is no limit to the number of benefit periods a person can have over their lifetime.

Within each benefit period, Medicare Part A provides coverage for up to 100 days of skilled nursing facility care. For the first 20 days of a covered SNF stay, Medicare covers 100% of the approved costs. From day 21 through day 100, beneficiaries are responsible for a daily copayment. For 2025, this daily copayment is $209.50. After day 100 in a benefit period, Medicare coverage for the SNF stay ends, and the beneficiary becomes responsible for all costs.

A new benefit period can begin if the beneficiary remains out of a hospital or SNF for at least 60 consecutive days. If they are then admitted to a hospital or SNF again, a new benefit period starts, and the coverage days reset. Medicare coverage for skilled nursing care continues as long as the skilled services are medically necessary, even if the patient is not actively improving. Skilled care is covered to maintain a patient’s condition or prevent decline, not solely for restoration.

Out-of-Pocket Costs

Beneficiaries incur out-of-pocket costs during a Medicare-covered Skilled Nursing Facility (SNF) stay. The Medicare Part A hospital deductible applies at the beginning of each benefit period. For 2025, this deductible is $1,676. If this deductible was already met by a qualifying hospital stay within the same benefit period, it does not need to be paid again for the SNF stay.

For days 1 through 20 of a Medicare-covered SNF stay, beneficiaries pay nothing. For days 21 through 100, a daily copayment of $209.50 per day is required in 2025. Beyond day 100 in a benefit period, the beneficiary is responsible for all costs of the SNF stay.

Medicare Part A does not cover certain items or services in an SNF. This includes personal care items, private duty nursing, or purely custodial care if skilled care is no longer deemed medically necessary. To help manage these out-of-pocket expenses, many beneficiaries have supplemental insurance. Medigap policies and some Medicare Advantage plans can provide additional coverage for these costs, depending on the specific plan chosen.

Options for Extended Care

When Medicare Skilled Nursing Facility (SNF) benefits are exhausted after 100 days in a benefit period or if skilled care criteria are no longer met, individuals have other avenues for continued care. One option is to pay for the continued SNF care privately.

Individuals who planned for potential long-term care needs may have a long-term care insurance policy. These policies are designed to cover extended nursing home stays or other long-term services that Medicare does not. Coverage details and benefits vary significantly based on the specific policy purchased.

Medicaid, a joint federal and state program, can also provide assistance with long-term nursing home care for eligible low-income individuals. Qualifying for Medicaid involves strict financial and medical eligibility requirements, including limits on income and assets. These limits vary by state and often require extensive financial review.

Another option is transitioning to home health care, if appropriate. Medicare Part A or Part B may cover some home health services for individuals who can return home but still require intermittent skilled nursing care or therapy. This can serve as a less intensive alternative to continued SNF care. Facilities have social work teams that assist with discharge planning to help beneficiaries and their families explore options for continued care.