Skilled nursing facility (SNF) care

Medicare Part A (Hospital Insurance) covers skilled nursing facility care  for a limited time (on a short-term basis) if you meet all of these conditions:

  • You have Part A and have days left in your benefit period  to use.
  • You have a  qualifying inpatient hospital stay
  • Your doctor or other health care provider has decided that you need daily skilled care (like intravenous fluids/medications or physical therapy). You must get the care from, or under the supervision of, skilled nursing or therapy staff.
  • You get these skilled services in a Medicare-certified SNF.
  • You need skilled services for one of these:
    • An ongoing condition that was also treated during your qualifying inpatient hospital stay (even if it wasn't the reason your were admitted to the hospital). 
    • A new condition that started while you were getting SNF care for the ongoing condition.

Your costs in Original Medicare

In each benefit period , you pay:

  • Days 1 - 20: $0. (Note: If you're in a Medicare Advantage Plan, you may be charged copayments during the first 20 days. Check with your plan for more information.)
  • Days 21 - 100: $204 each day
  • After day 100: All costs

Part A limits SNF coverage to 100 days in each benefit period.

Frequency of services

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and if, or how much, Medicare will pay for them.

What it is

Skilled care is nursing and therapy care that can only be safely and effectively performed by, or under the supervision of, professionals or technical personnel. It’s health care given when you need skilled nursing or skilled therapy to treat, manage, and observe your condition, and evaluate your care.

Medicare-covered services in a skilled nursing facility include, but aren't limited to:

Things to know

  • You may get skilled nursing care or therapy if it’s necessary to improve or maintain your current condition, or to prevent or delay it from getting worse. 
  • If you disagree with your discharge for any reason, you can appeal. 
  • You may not need a 3-day minimum inpatient hospital stay if your doctor participates in an Accountable Care Organization (ACO), or another type of Medicare initiative approved for a Skilled Nursing Facility 3-Day Rule Waiver. If your provider participates in an ACO, check with them to find out what benefits may be available. Medicare Advantage Plans may also waive the 3-day minimum. Contact your plan for more information.

Learn more about the situations that may impact your coverage and costs.

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