Medicare Rehabilitation and Long-Term Care: Where Coverage Changes

Adapted from Your Medicare Benefits, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.

Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.

Inpatient rehabilitation care

Inpatient rehabilitation can help if you’re recovering from a serious surgery, illness, or injury and need an intensive rehabilitation therapy program, physician supervision, and coordinated care from your doctors and other health care providers (including therapists).

Part A covers medically necessary care you get in an inpatient rehabilitation facility or unit (sometimes called an inpatient “rehab” facility, IRF, acute care rehabilitation center, or rehabilitation hospital). Your doctor or other health care provider must certify that you have a medical condition requiring intensive rehabilitation, continued medical supervision, and coordinated care from your providers.

Part B covers doctors’ services you get while you’re in an inpatient rehabilitation facility.

Costs What you pay for each benefit period in 2026 depends on how long you’re getting care:

• Days 1-60: After you pay the $1,736 deductible, you pay $0 each day.
• Days 61-90: You pay $434 each day.
• Days 91-150: You pay $868 each day while using your 60 lifetime reserve days. These are additional days that Medicare will pay for when you’re in a hospital for more than 90 days. You have a total of 60 reserve days that can be used once during your lifetime.
• After Day 150: You pay all costs. Note: You don’t pay a deductible for inpatient rehabilitation care if Medicare already charged you a deductible for care you got in a prior hospitalization within the same benefit period. This is because your benefit period starts on day one of your prior hospital stay, and that stay counts toward your deductible. For example, you won’t have to pay a deductible for inpatient rehabilitation care if:
• You’re transferred to an inpatient rehabilitation facility directly from an acute care hospital.
• You’re admitted to an inpatient rehabilitation facility within 60 days of being discharged from a hospital.

Things to know Medicare-covered inpatient rehabilitation care includes:

• Rehabilitation services, like physical therapy, occupational therapy, and speech-language pathology
• A semi-private room
• Meals
• Nursing services
• Prescription drugs
• Other hospital services and supplies

Medicare doesn’t cover these items and services:

• Private duty nursing
• A phone or television in your room (if there’s a separate charge for these items)
• Personal care items (like toothpaste, razors, or slipper socks)
• A private room, unless medically necessary

More information

• Go to “What do I pay for Part-A covered services?” on pages 3–4 to learn more about benefit periods.
• Visit Medicare.gov/coverage/inpatient-rehabilitation-care.

Long-term care

Long-term care (also called “custodial care” or “long-term services and support”) includes medical and non-medical care for people who have a chronic illness or disability. Most long-term care helps with basic personal tasks of everyday life, sometimes called “activities of daily living.” This includes things like dressing, bathing, and using the bathroom. Long-term care may also include home-delivered meals, adult day health care, transportation, and other services.

Long-term care is different from skilled nursing facility care. Since most long-term care is non-medical, Medicare and most health insurance, including Medicare Supplement Insurance (Medigap), don’t pay for long-term care.

Costs You pay all costs for non-covered services, including most long-term care.

Things to know

• You may qualify for long-term care through Medicaid (if you meet eligibility requirements in your state), or you can choose to buy private long-term care insurance.
• You can get long-term care at home, in the community, in an assisted living facility, or in a nursing home. It’s important to start planning for long-term care now so you can maintain your independence and make sure you get the care you may need, in the setting you want, now and in the future.

More information Visit Medicare.gov/coverage/long-term-care.

Long-term care hospital services

Long-term care hospitals typically provide care to patients with more than one serious medical condition. The patients may improve with time and care, and eventually return home. These hospitals usually give services like respiratory therapy, head trauma treatment, and pain management. Part A covers care in long-term care hospitals.

Costs What you pay for each benefit period in 2026 depends on how long you’re getting care:

• Days 1-60: After you pay the $1,736 deductible, you pay $0 each day.
• Days 61-90: You pay $434 each day.
• Days 91-150: You pay $868 each day while using your 60 lifetime reserve days. These are additional days that Medicare will pay for when you’re in a hospital for more than 90 days. You have a total of 60 reserve days that can be used once during your lifetime.
• After Day 150: You pay all costs.

Note: You don’t have to pay the Part A deductible for care you get in the long-term care hospital if you were already charged a deductible for care you got in a prior hospitalization within the same benefit period. This is because your benefit period starts on day one of your prior hospital stay, and that stay counts towards your deductible. For example, you won’t have to pay a deductible for your long-term hospital care if:

• You’re transferred to a long-term care hospital directly from an acute care hospital.
• You’re admitted to a long-term care hospital within 60 days of being discharged from a hospital.

More information

• Go to “What do I pay for Part-A covered services?” on pages 3–4 to learn more about benefit periods.
• Visit Medicare.gov/coverage/long-term-care-hospital-services.

Nursing home care

Nursing homes are facilities for people who usually need 24-hour care. Nursing homes can provide:

• Short-term care for people who need rehabilitation after surgery (like physical therapy after a hip or knee replacement) or skilled nursing to recover from an illness (like pneumonia)
• Long-term care (also called “custodial care” or “long-term services and support”) for people who need help with activities of daily living, like bathing, dressing, or eating. Medicare generally doesn’t cover long-term nursing home stays, unless you’re receiving skilled nursing care.

Part A may cover short-term nursing home or rehab care (up to 100 days) in a Medicare-certified nursing home after hospitalization. It must be medically necessary for you to get skilled nursing care (like if you need help changing sterile dressings).

Part B covers doctor visits and physical, speech, or occupational therapy, even if you get these services while in a nursing home.

More information

• Go to:
• “Home health services” on pages 52–54.
• “Long-term care” on pages 64–65.
• “Skilled nursing facility (SNF) care” on pages 103–105.
• Visit Medicare.gov/coverage/nursing-home-care.

Skilled nursing facility (SNF) care

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 you get when you need skilled nursing or skilled therapy to treat, manage, and observe your condition, and evaluate your care.

Part A covers SNF care for a limited time if you meet all these conditions:

• You have Part A and have days left in your benefit period to use.
• You have a qualifying inpatient hospital stay. This means a prior medically necessary inpatient hospital stay of 3 consecutive days or more, starting with the day the hospital admits you as an inpatient, but not including the day you leave the hospital. Time you spend at the hospital under observation or in the emergency room before you’re admitted doesn’t count toward the three-day qualifying inpatient hospital stay, even if you’re there overnight. You must enter the SNF within a short time (usually 30 days) of leaving the hospital.
• Your doctor or other health care provider certifies 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 you were admitted to the hospital).
• A new condition that started while you were getting SNF care for the ongoing condition.

Medicare-covered services in a SNF include, but aren’t limited to:

• A semi-private room (a room you share with other patients).
• Meals.
• Skilled nursing care.
• Occupational and physical therapy, if they’re needed to meet your health goal. Go to “Occupational therapy services” on pages 77–78 and “Physical therapy services” on page 87.
• Speech-language pathology services, if they’re needed to meet your health goal. Go to page 106.
• Medical social services.
• Medications.
• Medical supplies and equipment used in the facility.
• Ambulance transportation (when other transportation could endanger your health) to the nearest supplier of needed services that you can’t get at the SNF.
• Dietary counseling.

How often Medicare covers certain daily SNF services on a short-term basis.

Costs What you pay for each benefit period in 2026 depends on how long you’re getting care:

• Days 1–20: You pay $0 each day after you pay the $1,736 deductible. You don’t have to pay the deductible for skilled nursing facility care if you already paid it for care you got in a hospital during the same benefit period.

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: You pay $217 each day.
• Days 101 and beyond: You pay all costs. Part A limits SNF coverage to 100 days in each benefit period.

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 three-day minimum inpatient hospital stay if your health care provider participates in an Accountable Care Organization (ACO) that’s approved for a Skilled Nursing Facility Three-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 three-day minimum inpatient hospital stay. Contact your plan for more information.
• Medicare doesn’t cover non-medical long-term care.

More information

• Go to:
• “Ambulance services” on pages 10–11.
• “Long-term care” on pages 64–65.
• “What do I pay for Part-A covered services?” on pages 3–4 to learn more about benefit periods.
• Visit Medicare.gov/coverage/skilled-nursing-facility-care.
• Visit Medicare.gov/providers-services/coordinating-care.

Swing bed services

A rural or critical access hospital with a Medicare agreement can “swing” its beds and provide either acute hospital or Skilled Nursing Facility (SNF)-level care, as needed. Medicare covers swing bed services you get in certain Medicare hospitals.

Costs When swing beds provide SNF-level care, the same coverage and cost-sharing rules apply as though the services were provided in a SNF.

More information Visit Medicare.gov/coverage/swing-bed-services.

Source and further reading

Your Medicare Benefits — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.