Original Medicare Part A can cover a limited skilled nursing facility stay when you meet its requirements. The maximum is 100 covered days per benefit period, not an automatic entitlement to 100 days of care. Coverage can end earlier if the requirements are no longer met.
Conditions for a covered stay
- You have Part A and available days in the benefit period.
- You generally had a medically necessary inpatient hospital stay of at least three consecutive days, excluding the discharge day.
- You enter the skilled nursing facility within the allowed time, generally 30 days after leaving the hospital.
- You need daily skilled nursing or therapy for an eligible condition.
- The care is provided in a Medicare-certified skilled nursing facility.
Emergency-room and observation time before formal inpatient admission does not count toward the three-day requirement. Certain approved Accountable Care Organization arrangements and Medicare Advantage plans can waive that requirement. Confirm your own situation with the hospital and insurer.
Skilled care may qualify when it is needed to improve or maintain your condition, or prevent or delay deterioration. Lack of improvement alone is not the complete coverage test.
Original Medicare costs in 2026
| Days in the benefit period | Your covered-stay cost |
|---|---|
| 1–20 | $0 daily coinsurance after the applicable Part A deductible. Do not pay that deductible again if already paid for hospital care in the same benefit period. |
| 21–100 | $217 per day. |
| 101 onward | You pay the facility costs after Part A days are exhausted. |
The Part A deductible is $1,736 per benefit period in 2026. Other insurance may help with eligible costs. Medicare Advantage can use different copayments, including during the first 20 days, so check the plan’s documents.
Plan for care after coverage ends
Long-term personal or custodial care is different from covered skilled care. Ask the facility for written costs, a discharge plan and possible assistance resources. Medicaid has separate state eligibility rules and does not begin automatically when Medicare stops paying.
Read any notice ending coverage immediately and follow its appeal instructions if you disagree. Keep admission records and notices showing whether the hospital classified you as an inpatient or outpatient. Do not assume a short break in care resets the benefit period; ask Medicare or your plan how the break affects the remaining days.
Related coverage questions
- Nursing Home Care and Medicare: Understand the Difference
- Medicare Advantage and Nursing Homes: Skilled Care Versus Residence
- Medicare Home Health Care: Services, Eligibility and Costs