Medicare 100 Days Skilled Nursing: 2026 Day-by-Day Costs
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Key takeaways
- Original Medicare Part A covers up to 100 days of skilled nursing facility care in each benefit period, not each year.
- In 2026, Medicare.gov says you pay $0 a day for days 1-20, $217 a day for days 21-100, and all costs from day 101 on.
- The 100 days reset only when a new benefit period starts, after at least 60 days in a row without inpatient hospital care or skilled care in a skilled nursing facility.
- Coverage lasts only while the person needs skilled nursing or skilled rehab on a daily basis. Federal rules say the person does not have to be expected to improve.
- When coverage is ending, the nursing home must give a Notice of Medicare Non-Coverage. A fast appeal to the BFCC-QIO has a noon deadline, so check the date on the notice.
Short answer
Original Medicare Part A covers up to 100 days of skilled nursing facility care in each benefit period, not 100 days a year. In 2026, Medicare.gov says you pay $0 a day for days 1–20, $217 a day for days 21–100, and all costs from day 101 on.
The 100 days are a limit, not a promise. Coverage lasts only while the person needs skilled nursing or skilled rehab on a daily basis. When that need ends, coverage can stop well before day 100.
This guide goes deeper than our overview, does Medicare pay for a nursing home.
What do you pay for each day of a Medicare skilled nursing stay in 2026?
Under Original Medicare, the daily cost depends on which day of the benefit period you are on. Medicare.gov lists these 2026 amounts:
| Day of the benefit period | What you pay |
|---|---|
| Days 1–20 | $0 a day |
| Days 21–100 | $217 a day |
| Day 101 and after | All costs |
To add up these amounts for a specific number of days, use our Medicare skilled nursing facility cost calculator.
Federal rules say Medicare pays for all covered services for the first 20 days. For days 21–100, it pays for covered services except the daily coinsurance. By rule, that coinsurance is one-eighth of the year's Part A inpatient hospital deductible, which is $1,736 in 2026. If the facility's actual charge is lower, you pay the actual charge.
At $217 a day, all 80 days from day 21 to day 100 add up to $17,360. Medicare.gov describes the $0 days as coming after you pay the $1,736 Part A deductible. That deductible is not owed again for the nursing home stay if it was already paid for the hospital stay in the same benefit period. A separate guide covers which Medigap plans pay the daily coinsurance.
How does Medicare count the 100 days?
Medicare counts the 100 days within a benefit period, not within a calendar year or a lifetime. Federal rules say a benefit period begins on the day a person receives inpatient hospital or skilled nursing facility care.
A person must have days left in the benefit period for Medicare to pay. After 100 covered days, Medicare.gov says you pay all costs.
When do the 100 days reset?
The 100 days reset only when a new benefit period starts. Federal rules say a benefit period ends once a person has gone at least 60 days in a row without being an inpatient in a hospital, or in a skilled nursing facility at the skilled level of care.
The next time the person gets inpatient hospital or skilled nursing facility care, a new benefit period begins with a new set of 100 days. Medicare says there is no limit on the number of benefit periods. A new benefit period also brings a new Part A deductible. Original Medicare generally requires a new 3-day inpatient hospital stay before it covers skilled nursing care again. The 3-day rule section below explains when that stay may not be needed.
What is the 3-day hospital stay rule?
Original Medicare generally covers a skilled nursing facility stay only after a medically necessary inpatient hospital stay of at least 3 days in a row. Federal rules require at least 3 consecutive calendar days as an inpatient, not counting the day of discharge. Medicare.gov says you may not need the 3-day stay if your doctor participates in an Accountable Care Organization approved for a Skilled Nursing Facility 3-Day Rule Waiver.
- Observation does not count. Medicare.gov says time spent under observation or in the emergency room before you are admitted does not count toward the 3 days.
- The MOON notice. The hospital must give a Medicare Outpatient Observation Notice to people getting observation services for more than 24 hours.
- Status-change appeals. Since February 14, 2025, Medicare.gov says people with Original Medicare who were admitted as inpatients and then switched to observation can ask a BFCC-QIO for a fast appeal.
For what to ask the hospital before discharge, see how to choose a nursing home before a hospital discharge.
Do you have to go to the nursing home within 30 days?
Generally, yes. Federal rules say skilled nursing facility care generally must begin within 30 calendar days after discharge from the hospital. If starting within 30 days would not be medically appropriate, care may begin when it would be medically appropriate to start an active course of treatment.
The same 30-day idea applies if a person leaves the nursing home and needs to go back. Medicare says you may not need another 3-day hospital stay if you re-enter the same or another skilled nursing facility within 30 days, in the same benefit period. Otherwise, federal rules require a new qualifying hospital stay of at least 3 days in a row.
Why can Medicare stop paying before day 100?
Medicare can stop paying before day 100 when the person no longer needs skilled care on a daily basis. Federal rules require a daily need for skilled nursing or skilled rehab that, as a practical matter, can only be given as an inpatient in a skilled nursing facility.
- What "daily" means. Federal rules define it as skilled services needed and given 7 days a week. For skilled rehab only, when it is not offered 7 days a week, at least 5 days a week counts.
- Custodial care alone is not covered. Medicare.gov says Medicare doesn't cover custodial care, such as help with daily activities, if it's the only care you need.
Read more in short-term rehab vs. long-term care.
Does the patient have to keep improving for Medicare to pay?
No. Federal rules say a patient's restoration potential "is not the deciding factor" in whether skilled services are needed. Medicare.gov lists needing skilled nursing care or therapy "to improve or maintain your current condition" as a coverage condition.
CMS says that under the Jimmo v. Sebelius settlement, coverage "does not turn on the presence or absence of a beneficiary's potential for improvement." It depends on the person's need for skilled care, in skilled nursing facilities and other settings.
What notice do you get when Medicare coverage is ending?
The nursing home must give a written Notice of Medicare Non-Coverage (NOMNC). Federal rules say it must come no later than 2 days before covered services end. Medicare.gov says you should get it at least 2 days before.
Under federal rules, the notice must show the date coverage ends, the date you start to be responsible for payment, and how to ask for a fast review. That review is done by the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO). The CMS notice form includes the QIO's name and toll-free phone number.
What are the deadlines for a fast appeal?
The deadline is noon, but the two official sources describe it differently, so read the date on your notice.
| Step | What the source says |
|---|---|
| Deadline (federal rule) | 42 CFR 405.1202: by noon of the calendar day after you receive the notice |
| Deadline (Medicare.gov) | By noon the day before the end date on the notice |
| How to ask | Contact the BFCC-QIO in writing or by phone |
| QIO decision | Federal rule: no later than 72 hours after the request |
The CMS notice form itself uses the Medicare.gov wording: no later than noon of the day before the end date. The two deadlines fall on the same day when the notice arrives exactly 2 days before services end. Under the federal rule, if the QIO cannot accept the request, the deadline moves to noon of the next day it is available.
A late request is still reviewed as soon as possible, under the federal rule. But the 72-hour timeframe and the protection from paying while you wait do not apply. Medicare.gov says that if you keep getting services after the coverage end date, you may have to pay for them. Medicare Advantage plans have their own steps; see how to appeal a Medicare Advantage skilled nursing denial.
What does Medicare Advantage do differently?
Medicare.gov says Medicare Advantage plan members might not need a 3-day hospital stay and may be charged copayments during the first 20 days. Costs depend on the plan, so the table above applies to Original Medicare only.
What happens after day 100 in a skilled nursing facility?
After day 100 in a benefit period, Medicare Part A stops paying for the nursing home stay. Medicare.gov says that for days 101 and beyond, you pay all costs, because Part A limits skilled nursing facility coverage to 100 days in each benefit period.
- Part B can still pay for some care if you have Part B. Medicare.gov says Part B covers doctor visits and physical, speech, or occupational therapy, even if you get these services while in a nursing home. CMS's claims processing manual says that when a resident's Part A benefit days are exhausted, some medically necessary services, including outpatient physical therapy, speech-language pathology and occupational therapy, can be covered under Part B.
- Medicare still covers other care. Medicare.gov says that even if Medicare doesn't cover your nursing home care, you'll still need Medicare to cover your hospital care, doctor's services, drugs and medical supplies while you're in a nursing home.
- Medigap does not add days beyond day 100. Medicare's guide to choosing a Medigap policy says some plans pay all or part of the daily coinsurance for days 21–100 (Plans A and B don't cover it), and that Medigap policies generally don't cover long-term care, like non-skilled care you get in a nursing home. See which Medigap plans pay the skilled nursing coinsurance.
- A new 100 days needs a new benefit period. That takes at least 60 days in a row as described in when the 100 days reset, and generally a new qualifying hospital stay. Federal rules say that, for ending a benefit period, a person counts as a skilled nursing facility inpatient if their care there met the skilled level of care requirements. Medicare's booklet says the benefit period ends when you haven't gotten inpatient hospital care or skilled care in a SNF for 60 days in a row, so time at a custodial level generally does not keep the benefit period open. The rules also set presumptions based on how Medicare or Medicaid claims for the stay were paid.
The nursing home stay itself must then be paid another way. Medicare.gov says most people who enter nursing homes start by paying for their care out-of-pocket, and it lists these other ways to pay:
- Medicaid, for people who meet their state's eligibility rules. Medicare's booklet Medicare Coverage of Skilled Nursing Facility Care (Product No. 10153) says most health care costs may be covered if you qualify for both Medicare and Medicaid. See how Medicaid pays for a nursing home.
- Long-term care insurance. See how long-term care insurance pays for a nursing home.
- Life insurance. Medicare.gov says some insurance companies will let you use your life insurance policy to pay for long-term care.
VA.gov says veterans may be able to get VA benefits to help pay for nursing home care, depending on income and the level of service-connected disability. See does the VA pay for nursing home care. For how skilled care differs from custodial care, see short-term rehab vs. long-term care.
How can you compare homes for a short-term stay?
You can look up any certified home by name, city or ZIP code on our nursing home search. Each home's page has a Quality measures section with a separate table for short-stay residents, shown next to state and national averages. You can also compare nursing homes side by side.