Medicare & Medicaid · Skilled nursing facility coverage

Does Medicare Pay for Nursing Home Care?

Only for up to 100 days per benefit period, in a skilled nursing facility, and only after a qualifying inpatient hospital stay of at least 3 consecutive days. Days 1–20 are covered in full; days 21–100 require a daily coinsurance; after day 100, Medicare pays nothing. It does not cover an ongoing nursing home stay for custodial care at any point. Once the 100 days end, Medicaid — with its own separate income and asset eligibility rules — is what actually covers continuing nursing home care for most families.

Last reviewed 2026-08-19.

The 3-day hospital stay rule

To qualify for Medicare-covered skilled nursing facility care, the patient generally needs a prior inpatient hospital stay of at least 3 consecutive days — not counting the discharge day. This is stricter than it sounds: time spent under "observation status," a common hospital billing classification that looks and feels like admission but isn't, does not count toward the 3 days. A family that assumes a multi-day hospital visit automatically qualifies can be surprised to learn it was observation the whole time. The skilled nursing facility stay also generally has to begin within 30 days of the hospital discharge.

The 100-day limit, day by day

Days 1–20: Covered in full — no coinsurance.
Days 21–100: A daily coinsurance applies (Medicare.gov publishes the current amount each year — verify the figure for the current year directly, since it changes annually).
After day 100: Medicare pays nothing for that benefit period. The patient is responsible for the full daily cost unless another payer — Medicaid, long-term-care insurance, or private pay — applies.

A benefit period resets after a 60-consecutive-day stretch with no hospital or skilled nursing facility stay, which can start a fresh 100-day allowance if a later qualifying hospital stay occurs. Going back into the hospital before that 60-day gap has passed continues the same benefit period rather than resetting it.

What "skilled" actually means here

Medicare's nursing facility coverage is built around skilled care — services like wound care, IV therapy, or physical therapy that require a licensed professional — not custodial help with daily activities. Once a patient's needs shift from skilled recovery care to ongoing custodial support (help with bathing, dressing, eating), Medicare coverage for the stay can end even before day 100, regardless of whether the patient still needs a nursing home level of care.

When the 100 days run out

This is the point where many families discover a second, separate eligibility problem: continuing nursing home care has to be paid some other way, and Medicaid — the program that actually covers long-term custodial nursing home care — has its own income and asset limits with nothing to do with Medicare. In more than 24 states, someone whose monthly income is over that limit can still qualify using a Qualified Income Trust, commonly called a Miller Trust — it redirects the excess income so it isn't counted toward the cap. See the complete Miller Trust guide to check whether your state uses this mechanism.

Frequently asked questions

Does Medicare pay for nursing home care?

Only for a limited, specific situation: up to 100 days in a skilled nursing facility per benefit period, and only after a qualifying inpatient hospital stay of at least 3 consecutive days. It does not pay for an ongoing nursing home stay for custodial care, no matter how long someone has been a Medicare beneficiary. Once medically necessary skilled care ends, or the 100 days run out, Medicare coverage for that stay stops.

What counts as a qualifying hospital stay for Medicare skilled nursing coverage?

At least 3 consecutive days as a formally admitted inpatient — not counting the day of discharge, and not counting time spent under "observation status," which looks like a hospital stay but doesn't count toward the requirement. This distinction trips up a lot of families: a multi-day hospital visit that was technically observation, not admission, doesn't qualify someone for Medicare-covered skilled nursing afterward. The skilled nursing facility admission also generally has to happen within 30 days of the hospital discharge.

How much does Medicare cover for skilled nursing facility days 1 through 100?

Days 1–20 are covered in full — no coinsurance. Days 21–100 require a daily coinsurance amount that changes annually (Medicare.gov publishes the current figure each year). After day 100 in a benefit period, Medicare pays nothing at all for that stay, and the patient is responsible for the full cost unless Medicaid or another payer applies.

What happens after Medicare's 100 days run out?

This is the exact moment many families discover a second, separate problem: continuing nursing home care has to be paid for some other way — privately, through long-term-care insurance, or through Medicaid, which has its own income and asset eligibility rules unrelated to Medicare. Someone whose income is a few hundred dollars over their state's Medicaid limit doesn't automatically qualify just because Medicare has stopped paying; in most income-cap states, a Qualified Income Trust (Miller Trust) is the standard tool for that specific gap.

Does a new hospital stay reset Medicare's 100-day nursing home benefit?

Yes, but only after a real break: the benefit period resets once someone has gone 60 consecutive days without being in a hospital or skilled nursing facility. A new qualifying hospital stay after that reset can start a fresh 100-day benefit period. Going back into the hospital before that 60-day gap has passed does not reset the count — it continues the same benefit period.

Miller Trust Guide is an informational publisher, not a law firm or an insurance agency — we don't sell Medicare plans and this page is not medical or legal advice. See also does Medicare pay for long-term care, assisted living coverage, and home health coverage. See the editorial process and about the author.