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Skilled Nursing Facility Bills: Your Costs and When Coverage Ends

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.

What You Pay

What do I pay for SNF care in 2025?

Each time you start a new benefit period you must pay $1,676 (in 2025) before Medicare starts to pay. However, you don’t have to pay the Part A deductible for skilled nursing facility care if you already paid it for care you got in a hospital during the same benefit period. During a benefit period, what you pay depends on how long you’re getting skilled nursing facility care:

  • Days 1–20: You pay $0 each day after you pay the $1,676 amount.
  • Days 21–100: You pay $209.50 each day.
  • Days 101 and beyond: You pay all costs. You must also pay all additional charges not covered by Medicare (like phone and laundry fees).

Note: Your SNF costs may be different if you’re in a Medicare Advantage Plan. Check with your plan.

Ways you can get help with costs

  • Help from your state: If your income and resources are limited, you may be able to get help to pay for SNF care, non-medical long-term care, or other health care costs. If you qualify for both Medicare and Medicaid, most health care costs may be covered. You may also qualify for the Medicaid nursing home benefit or the Programs of All-inclusive Care for the Elderly (PACE). Call your State Medical Assistance (Medicaid) office for more information. To find the number, visit Medicaid.gov/about-us/where-can-people-get-help-medicaid-chip/index. html#statemenu.
  • Employer or union coverage: If you have health coverage from an employer or union, check with your benefits administrator to determine what’s covered.
  • Medigap policy: If you have Original Medicare, you may also have a Medicare Supplement Insurance (Medigap) policy to fill gaps in your coverage. Some Medigap policies pay all or some of the SNF coinsurance for days 21–100. Check your policy or call the insurance company to find out if your policy includes coverage for the Medicare SNF coinsurance.

For more information about Medigap policies, visit Medicare.gov/health-drug-plans/medigap or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

  • Long-term care insurance: If you have long-term care insurance, check your policy or call the insurance company to find out if skilled or non-medical long-term care is covered.

For more information about help paying for health care, call your State Health Insurance Assistance Program (SHIP). Visit shiphelp.org to get the phone number of your local SHIP.

Your Care in a Skilled Nursing Facility

Staff will work with you, using your assessments, to develop your care plan.

What’s an assessment?

When you go to a SNF, a team of staff from different medical fields (depending on your health needs) plans your care. Your SNF care is based on your doctor’s orders, and information the team gathers when they do daily assessments of your condition. Your doctor and the SNF staff (with your input) use the assessments to decide what services you need and your health goal (or goals).

Medicare requires an initial assessment within your first 8 days of SNF care. The SNF uses this assessment to plan and manage your care, and Medicare uses it to determine appropriate payment to the SNF. The SNF must also record any other assessments that you need during your stay because of changes in your condition.

An assessment includes information about:

  • Your current physical and mental condition
  • Your medical history
  • Medications you’re taking
  • How well you can do daily living activities, like bathing, dressing, eating, getting in and out of bed or a chair, moving around, and using the bathroom
  • Your speech
  • Your decision-making ability
  • Physical limitations, like problems with your hearing or vision, paralysis after a stroke, or balance problems

What’s a care plan?

After your health condition is assessed, SNF staff prepare or update your care plan. You (if you’re able), your family, or someone acting on your behalf have the right to take part in planning your care with the SNF staff. Let the staff know if you want to be included. Getting involved in your care plan helps you understand how the care you get will help you reach your health care goals.

Your care plan may include:

  • What kind of services you need
  • What type of health care professional should give you the services
  • How often and for how long you’ll need the services
  • What kind of equipment or supplies you need, like a wheelchair or feeding tube
  • Your special diet, if you need one
  • Your health goal (or goals), and how your care plan will help you reach it

Any time your health condition is assessed, SNF staff will update your care plan.

When Your SNF Coverage Ends

What if I think my SNF coverage is ending too soon?

When Medicare coverage of your SNF stay is ending because it’s no longer medically reasonable and necessary or is considered non-medical long-term care, you’ll get a written notice from your provider called the “Notice of Medicare Non-Coverage” (NOMNC).

If you’re getting Medicare-covered services from a SNF, and you think your Medicare-covered SNF services are ending too soon, you can ask for a fast appeal. Your NOMNC will tell you how to ask for a fast appeal. (The notice might call it an “immediate” or “expedited” appeal.) If you don’t get this notice, ask your provider for it.

How does a fast appeal work?

With a fast appeal, an independent reviewer called a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) will decide if your services need to continue.

  • Request the appeal by calling your BFCC-QIO at the number provided in your Notice of Medicare Non-Coverage (no later than the time shown in the notice).
  • Ask your doctor or other health care provider to submit any information to the BFCC-QIO that may help your case.
  • If you miss the deadline, you may still have appeal rights:
  • If you have Original Medicare, call your BFCC-QIO.
  • If you’re in a Medicare Advantage or other health plan, call your plan or your BFCC-QIO.

The SNF isn’t required to give you written notice when you’re out of benefit days, and they’re going to start charging you. They may choose to notify you, but it’s important to keep track of the number of benefit days you have left.

What else should I know?

When Medicare coverage of your SNF stay is ending because continued care isn’t medically reasonable and necessary or is considered non-medical long-term care and you choose to remain in the SNF, you may have to pay for SNF care. If you have Original Medicare, the SNF must send you the “Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage” (SNF ABN) or a SNF denial letter before they can tell you to pay.

This notice tells you:

  • The date your Medicare coverage will end (and you must start to pay).
  • Why your stay isn’t (or is no longer) covered.
  • The estimated cost of the noncovered care.
  • Your right to ask the SNF to submit a claim to Medicare so that you can get an official payment decision from Medicare. This type of claim is sometimes called a “demand bill.”
  • If you ask to have a claim submitted for your SNF stay, you aren’t required to pay any coinsurance, or for any services and supplies Medicare doesn’t cover, until you’re informed of Medicare’s decision
  • Where you (or someone acting on your behalf) should sign to show you got the notice.

You can choose to pay for skilled care yourself when your SNF care coverage ends. Check with the SNF to find out how much it costs. Go to page 12 for information on ways you can get help to pay skilled and non-medical long-term nursing care costs.

It’s important to plan ahead

When you leave the SNF, you may need help with grocery shopping, bathing, dressing, or transportation. Or, you may need to think about home health care.

If you need non-medical long-term care in a nursing facility after you’re discharged from the SNF, you may want to start thinking about where you want to go. If the SNF you’re in has a bed available, and you’re happy with the care you’ve had so far, you may want to stay there.

Remember, Medicare doesn’t cover non-medical long-term care if it’s the only kind of care you need.

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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