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Qualifying for Medicare Skilled Nursing Facility Coverage

Adapted from Medicare Coverage of Skilled Nursing Facility Care, 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.

Medicare Coverage

Will Medicare cover SNF care?

Medicare will cover SNF care only if all of these are true:

  • You have Medicare Part A (Hospital Insurance) and have days left in your benefit period to use. Go to page 8 for information on benefit periods.
  • You have a medically necessary inpatient hospital stay of 3 consecutive days or more (called a “qualifying hospital stay”). When determining if your stay was 3 days:
  • You count the day you’re admitted to the hospital as an inpatient.
  • You don’t count the day you’re discharged.

You must enter the SNF within a short time (generally 30 days) of leaving the hospital.

Medicare will cover SNF care only if all of these are true:

  • After you leave the SNF, if you re-enter the same or another SNF within 30 days, you may not need another qualifying 3-day inpatient hospital stay to get more SNF benefits. This is also true if you stop getting skilled care while in the SNF and then start getting skilled care again within 30 days. If you’re in a Medicare Advantage Plan, you might not need to be in the hospital for 3 consecutive days. Check with your plan about costs for a SNF stay.
  • Your doctor has ordered inpatient services in a SNF that require the skills of professional personnel, and the services are provided or supervised by these skilled personnel. Skilled personnel include doctors, registered nurses, licensed practical and vocational nurses, physical and occupational therapists, speech-language pathologists, or audiologists.
  • You need to get the required skilled care daily and the services, as a practical matter, can only be given when you’re an inpatient in a SNF. If you’re in a SNF for skilled therapy services only, your care is considered daily care if the therapy services are needed and provided 5–7 days a week.
  • You need skilled services for either:
  • An ongoing condition that was also treated during your qualifying 3-day 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. For example, if you’re in a SNF because you broke your hip and then you have a stroke, Medicare may cover therapy services for the stroke, even if you no longer need therapy for your hip.
  • The skilled services must be reasonable and necessary for the diagnosis or treatment of your condition.
  • You get these skilled services in a Medicare-certified SNF.

How long does Medicare cover SNF care?

Medicare uses a period of time called a benefit period to keep track of how many days of SNF benefits you use, and how many are still available. A benefit period begins on the day you start getting inpatient hospital or SNF care. You can get up to 100 days of SNF coverage in a benefit period.

Your benefit period ends when you stop getting skilled nursing facility care for 60 days in a row. If you’re admitted to the SNF again after those 60 days, a new benefit period will start. You must pay the Part A deductible each time you start a new benefit period. This could be multiple times in a calendar year (January–December).

Visit Medicare.gov/coverage/skilled-nursing-facility-care to learn more about benefit periods and how they might work in your situation

What if I stop getting skilled care in the SNF, or leave altogether? How does this affect Medicare coverage if I need skilled care in a SNF later on?

This depends on how long your break in SNF care lasts.

If your break in SNF care lasts for less than 30 days:

  • You don’t need a new 3-day inpatient hospital stay to qualify for coverage of more SNF care, but you need to meet all other coverage requirements listed on pages 6–7.
  • Your current benefit period would continue. This means that you can only get SNF care for however many unused SNF days are left in your current benefit period.

If your break in SNF care lasts at least 30 days (but fewer than 60): Medicare won’t cover additional SNF care unless you meet all of the coverage requirements on pages 6–7.

If your break in SNF care lasts 60 days or more:

  • Medicare won’t cover additional SNF care unless you meet all of the coverage requirements on pages 6–7.
  • Your current benefit period would end and, if you meet the coverage requirements, a new benefit period would start. This means that you’d be eligible for up to 100 days of SNF benefits in your new benefit period.

Examples of Medicare SNF coverage

In these 3 examples, assume the patients met all the requirements for Medicare coverage of SNF care (pages 6–7). They’re then admitted to a SNF because they need skilled care and are discharged from the SNF before their benefit period ends.

Example 1: Out of the SNF for less than 30 days

Mrs. Perkins got 10 days of Medicare-covered SNF care after she was hospitalized when she broke her leg. Her Medicare-covered SNF care ended when she stopped needing skilled care. She chose to go home rather than pay for non-medical long-term care. After 10 days, her doctor decided she needed more skilled care for her broken leg and she was readmitted to the SNF. Medicare will cover this SNF stay. She has 90 days of coverage left in her benefit period.

Example 2: Out of the SNF for at least 30 but less than 60 days

Mr. Jones got 20 days of Medicare-covered SNF care after he was hospitalized when he had a stroke. His Medicare-covered SNF care ended when he stopped needing skilled care. He chose to stay in the SNF and pay for 2 days of non-medical long-term care before he went home. After 34 days, his doctor readmitted him to the hospital for 4 more days because of his stroke. He was then admitted to a SNF because he needed skilled care. Even though Mr. Jones was out of the SNF for more than 30 days, Medicare will cover this SNF stay because he had a new 3-day qualifying inpatient hospital stay. He has 80 days of coverage left in this benefit period.

Example 3: Out of the SNF for at least 60 days

Mrs. Smith got 20 days of Medicare-covered SNF care after she was hospitalized when she had back surgery. Her Medicare-covered SNF care ended when she no longer needed skilled care. She chose to go home rather than pay for non-medical long-term care. After 65 days, she was hospitalized for 3 days due to a fall. She was then admitted to a SNF because she needed skilled care. Since she was out of the SNF for more than 60 days, her benefit period ended. Her new 3-day qualifying inpatient hospital stay starts a new benefit period. Medicare will cover up to 100 days of SNF care in this new benefit period.

If I’m in a SNF but must be readmitted to the hospital, will the SNF hold my bed for me?

Ask the SNF if it will hold a bed for you and if there’s a cost. For some Medicare-Medicaid patients in some states, a bed may be available at the same facility if more skilled care is needed after a hospital stay. However, depending on the state and your Medicaid eligibility, you may have to go to another SNF if a bed isn’t available.

Note: Go to pages 15–17 for information about what happens when your SNF coverage ends.

What does Medicare cover when I qualify for SNF care?

Medicare covers:

  • Semi-private room (a room you share with other patients)
  • Meals
  • Skilled nursing care
  • Medical social services
  • Medications
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation would endanger your health) to the nearest supplier of medically-necessary services that aren’t available at the SNF (including the return trip)
  • Dietary counseling

Medicare covers physical therapy, occupational therapy, and speech language pathology services if they’re needed to meet your health goal. A health goal is the expected result of your treatment, like being able to walk a certain distance or climb stairs.

Source and further reading

Medicare Coverage of Skilled Nursing Facility Care — 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.

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