Medicare does not cover long-term nursing home care when custodial care is the only care needed. Part A may cover short-term skilled nursing facility care for rehabilitation or skilled nursing after a qualifying hospital stay when all coverage requirements are met.
Skilled nursing facility requirements
Under Original Medicare, the person must have Part A and available days in the benefit period. A qualifying inpatient hospital stay generally lasts at least three consecutive days, not counting the discharge day. Observation and emergency department time do not count as inpatient days. The person generally must enter a Medicare-certified skilled nursing facility within 30 days after leaving the hospital.
A provider must determine that daily skilled nursing or therapy is needed for a condition treated during the hospital stay or a condition that began during the covered skilled nursing stay. Covered services can include a semiprivate room, meals, skilled nursing, therapy, medications, supplies, and other services in the facility.
Medicare does not require improvement as the only basis for coverage. Skilled care can be covered when it is needed to maintain a condition or prevent or slow deterioration. The daily skilled need and other requirements still apply.
Costs and limits
In 2026, the person pays $0 per day for days 1 through 20 after any applicable Part A deductible, $217 per day for days 21 through 100, and all costs after day 100 in a benefit period. Medicare does not pay the ongoing residential cost after skilled coverage ends.
Medicare Advantage plans must cover skilled nursing facility care but can use different copayments, networks, and authorization rules. Some plans waive the three-day hospital requirement. The plan’s rules must be checked before admission when possible.
What to do next
- Ask the hospital whether the stay is inpatient or observation.
- Confirm that the facility is Medicare-certified or in the plan network.
- Request written notice before covered skilled care ends and review appeal rights.
- Read Medicare’s pages on skilled nursing facility care and nursing home care.
Sources
Coverage and costs can change each calendar year. Check current Medicare rules and current plan documents before receiving care. A provider’s estimate is not a Medicare coverage decision. Final payment depends on the claim and the applicable coverage requirements.
Last reviewed: August 2026. Medicare rules and plan benefits can change.