What happens to my Medicare coverage if I enter a skilled nursing facility for rehab but then need long-term care?

Question

Leslie Kaz · Accepted Answer

When you enter a skilled nursing facility (SNF) for rehab, Medicare Part A typically covers up to 100 days per benefit period, provided you meet eligibility requirements (e.g., a qualifying 3-day hospital stay, skilled care needs, and admission within 30 days of hospital discharge). Here’s how it breaks down:

Days 1–20: Medicare covers the full cost of SNF care (assuming the facility is Medicare-certified and care is medically necessary).
Days 21–100: You pay a daily coinsurance ($204 in 2025), and Medicare covers the rest. Supplemental insurance (like Medigap) may cover this coinsurance.
After 100 days: Medicare Part A stops covering SNF care, regardless of whether you still need rehab or have transitioned to long-term care.

Gary Church · Answer

Medicare covers skilled nursing facilities for rehab. Medicare does not cover long-term care. Depending on your income level, you may qualify for Medicaid assistance for LTC.

Mike Alexander · Answer

Medicare Part A covers SN at 100% fir 1st 20 days, for days 21 to 100 you have a copay of $217 per day for up to 100 days
Medicare does not cover Long term care, you would need an Ltc policy in place to cover a nursing home.

Mark Bilgere · Answer

If you need long term care after a stay in a skilled nursing facility, your Medicare will continue to pay it's designated Part A and Part B benefits. However, Medicare Parts A and B do not cover any Long Term Care, so your Medicare will not help with the cost of a nursing home, or custodial care. All of those costs will be out of pocket.

Answered by Mark Bilgere on November 3, 2025

Broker Licensed in TX, AR, IN & LA, MN, NE & OK

Answered by Mark Bilgere Medicare Insurance Agent

Daniel Brechin · Answer

Medicare covers the first 20 days in the nursing home. 0 copay for 1-20days after that there's daily copays till 100 days

Norman Smith · Answer

Medicare coverage continues. It will be needed for Doctors, testing, surgeries, etc. But Medicare does not cover Long-Term Care. Long-Term Care is completely separate, and you can always see in the "Medicare and You" book each year that there is no coverage.
There are very few Long-term care companies that offer policies that cover LTC care. Forbes Magazine in January of 2025 notes that Bankers Life offers the best policy regarding that coverage. I can assist with that if you are looking to cover yourself or your family.

Voss Speros · Answer

God of Medicare with another Medicare question. The question is, what happens to my Medicare if I enter a skilled nursing or rehab? But then, what if I need long-term care? So, if you're on a Medicare Advantage plan, what's the other advantage plan for a strong advantage plan? You go from a hospital to a skilled nursing facility, and you're there for 20 days. But maybe you need more than that. Who knows? Maybe you're gonna have to move into long-term care. Then you're only gonna get a max of 100 days out of your plan.

So, the first 20 days are covered. Then you pay a co-payment for the next 40 to 60 days. And then from there on, there's a little bit more covered. So, on original Medicare, you're just covered because someone picks it up for the 100 days if you need longer than that. After that, you either go to assisted living or you stay in a skilled nursing facility. Then you're gonna need to pick up state Medicaid or pay for it out of pocket.

So, you gotta pull your wallet out and pay for the care you need because Medicare covers your health care needs, but it doesn't cover your assisted living needs. So, that assisted living or long-term skilled nursing needs to be covered out of pocket, private pay, or through a long-term care insurance policy or state Medicaid. I hope that helps. Give us a call if you need me. We'll send an agent out there and get you going. Have a good day!

Paul Potter · Answer

Medicare doesn't cover long term care.  It does cover medical conditions while on long term care.

Based on the federal deficit, don't expect it to get any better.

Joel Gregory Craven · Answer

All Medicare advantage carriers follow most of the same rules as original Medicare, however each carrier sets their plan with different copays and numbers of day which that copay applies. Some folk switch out of their Medicare advantage plan when they enter the long term care facility. Please don’t confuse rehab (swing bed hospital) with long term custodial care. If the member needs help with activities of daily living like dressing eating bathing etc ….that is not medical…. That’s total custody of the persons wellbeing care survival feedings etc. Total custody would be covered under a long term care policy or State Medicaid if they are low income, but not Medicare or a medical policy. There is a special election SEP for being institutionalized in a rehab or long term care facility. Then when they move out of the rehab or LTCF, they will generally have a new SEP to enroll back in a mapd. Always contact your agent and get them to help you navigate your plan options. Feel free to reach out to our agency which is licensed and appointed in many states and will consider getting set up in your state to help you be one of our wonderful customers!!!

Answered by Joel Gregory Craven on August 4, 2025

Broker Licensed in MS, AL, AZ & 5 other states

Answered by Joel Gregory Craven Medicare Insurance Agent

Robert Vaughan, R.Ph., MBA · Answer

As long as you continue to pay your Medicare premiums nothing will happen to your Medicare coverage, but Medicare does not pay for long-term care. You will be responsible for 100% of the cost of your long-term care.

Answered by Robert Vaughan, R.Ph., MBA on May 6, 2025

Broker Licensed in CA, AZ, ID, NM, NV & TX

Answered by Robert Vaughan, R.Ph., MBA Medicare Insurance Agent

Angie Templin · Answer

Medicare can help to pay for care up to 100 days as long as there is a recovery plan. If no recovery is possible or if your stay exceeds 100 days, you will be cosidered self pay. Lower income persons may qualify for benefits under your state's Medicaid program

Answered by Angie Templin on May 5, 2025

Broker Licensed in TX

Answered by Angie Templin Medicare Insurance Agent

Elliott Klepner · Answer

Medicare covers Skilled Nursing Facilities for the first 20 days, and then there are copays depending on your plan. Unfortunately, Medicare does not cover long-term care. There are Insurance policies and Annuities that can be used to cover long-term care.

Answered by Elliott Klepner on November 12, 2025

Broker Licensed in FL

Answered by Elliott Klepner Medicare Insurance Agent

David Moscowitz · Answer

Most Medicare plans will cover the skilled nursing portion of the medical coverage, in the home ,but the long term care is a separate issue altogether.
There are long term care plans but they need to be planned well in advance in order for coverage.

Harshil Patel · Answer

Medicare covers short-term skilled care, not custodial or long-term care. Once Medicare stops paying (when care is no longer skilled or you hit 100 days), you'll need to pay privately, use LTC coverage,or explore Medicaid for the costs of ongoing care. You should talk to the social worker if Medicaid is an option, otherwise you will need to explore LTC plans.

Answered by Harshil Patel on January 19, 2026

Broker Licensed in NJ

Answered by Harshil Patel Medicare Insurance Agent

Mark Michael · Answer

This far Medicare has a limit  at 100 days for long term care.  Thereafter you are on your own.  Best if when young invest in a long term care.  When older it is very expensive and limited.

Jim Tretola · Answer

Your Medicare coverage continues as if you lived at home. Unfortunately, Medicare does not pay for long term care and that is why people are looking into fixed index annuities and other insurance products that have a LTC component in them, without needing medical underwriting. Younger people should seriously consider buying LTC when they can afford it and can qualify for it.

Answered by Jim Tretola on November 8, 2025

Broker Licensed in NJ, CA, CT & 6 other states

Answered by Jim Tretola Medicare Insurance Agent

Michael Pyers · Answer

Skilled nursing is only for 100 days. After that, if you need long term care it entirely at your expense. Several options - if you had long term care insurance, it would pay at least part of your stay. If not, and you have limited resources the state may pay for the stay through Medicaid.

Answered by Michael Pyers on August 20, 2025

Broker Licensed in OH & MI

Answered by Michael Pyers Medicare Insurance Agent

Rich Baker · Answer

If the following conditions are met:
- a qualifying hospital stay of at least 3 days
- you need specialized care 
- the reason for the SNF stay is the same as the hospital stay

The your medicare Part A (and Medigap and most Medicare Advantage Plans) cover the first 20 days in a Skilled Nursing Facility. Days 21-100 are $217 per day. Medigap Plan G covers this cost. Medicare Advantage plans can set their own copay schedule, but in general the follow the Part A copays. Under Medicare Advantage you pay the $217 per day (or whatever their copay schedule is) from day 21-100, or until you hit your Maximum Out Of Pocket Maximum, which ever comes first. 

Once you hit day 101, Medicare no longer covers a SNF stay, so under original Medicare, Medicare + Medigap, or Medicare + Medicare Advantage, you pay 100% of the cost. 

If your SNF rehab stay turns into Long Term (custodial) care, no matter what day this happens, Medicare no longer covers the cost of the stay, so neither will Medigap or Medicare Advantage. You will have to self-pay, pay with your Long Term Care Insurance, or if on Medicaid, Medicaid may pay. 

I recommend talking to a broker about your situation to understand how your specific coverage will handle this situation.

Kris Moen · Answer

Medicare will help you get back on your feet—but it won’t pay to stay there long-term. Medicare covers short-term rehab (up to 100 days max)

Hannah Skinner · Answer

Medicare Part A covers skilled nursing facility care for the first 20 days in a benefit period. If you have a Medicare supplement this could be more. Medicare does not cover long-term care. You will still have Medicare during the period that you require long-term care, but a Long-Term Care Plan would be what you needed to cover the cost.

Answered by Hannah Skinner on September 18, 2025

Agent Licensed in SC, AL, AR & 44 other states

Answered by Hannah Skinner Medicare Insurance Agent

Cody Brown · Answer

Medicare does not cover long term care. If you are transitioned from skilled nursing to long term care, you would need to use outside insurance or self pay.

Robert Barco · Answer

Medicare will cover the skilled nursing facility, but Medicare part A coverage will end once Long -Term Care starts. You will be responsible for all Long-Term Care costs unless you have Long-Term Care insurance or qualify for Medicaid.

Answered by Robert Barco on May 6, 2025

Broker Licensed in OH

Answered by Robert Barco Medicare Insurance Agent

Becki Jennings · Answer

Medicare has a Skilled Nursing Facility benefit up to 100 days per benefit period. Once the Skilled Nursing Benefit has been exhausted, the patient will need to arrange payment outside of Medicare coverage. This may mean Medicaid, Long-Term Care Coverage, or Private Pay.

Answered by Becki Jennings on June 4, 2025

Agent Licensed in MO

Answered by Becki Jennings Medicare Insurance Agent

Jeffrey Adams · Answer

For the first 20 days in Skilled Nursing, Medicare covers the cost 100%, as long as you have spent 3 days as an inpatient in the hospital before admission.  If you have a Medicare Advantage plan, the 3 days requirement is usually waived.  
After day 20, you pay a daily copay of $217 per day until day 100, which is the maximum Medicare covers.  If you have a Medicare Supplement plan, it will usually cover that cost.  A Medicare Advantage plan usually has a copay nearly the same, which you will pay until you hit your plans maximum out of pocket.
If you are still in Skilled Nursing beyond 100 days, you are responsible for the full cost of the care unless you have some type of Long Term Care Insurance.

Pamela Fugitt-Hetrick · Answer

Medicare will cover up to 20 days of skilled nursing after a 3 day or longer inpatient stay. There is up to 100 days per incident of additional days that may be available for a daily charge after that. Medicare doesn't cover long-term care.

Answered by Pamela Fugitt-Hetrick on June 8, 2026

Agent Licensed in CA

Answered by Pamela Fugitt-Hetrick Medicare Insurance Agent

Fred Manas · Answer

If you initially enter a skilled nursing facility for rehabilitation under Medicare Part A, and then your needs transition to requiring long-term care, your Medicare coverage will likely end after the 100-day benefit period, unless other specific conditions are met. Medicare generally does not cover long-term care needs, such as custodial care or chronic care, in a skilled nursing facility. 
Here's a more detailed breakdown:
Initial Medicare Coverage:
Part A:
Medicare Part A can cover up to 100 days of skilled nursing facility care in a benefit period, provided you meet certain criteria, including having a 3-day hospital stay prior to the SNF stay. 
100-Day Benefit:
Medicare will generally cover the first 20 days with no copay, and then a coinsurance amount (currently $209.50 per day in 2025) for days 21-100. 
Intensive Rehabilitation:
The coverage is intended for intensive rehabilitation and medical supervision, not for chronic or custodial care. 
Transition to Long-Term Care:
Medicare Coverage Ends:
.
If your condition requires long-term care beyond the 100-day benefit period, Medicare coverage will typically stop. 
Out-of-Pocket Costs:
.
You will be responsible for the cost of care in the SNF after the 100-day limit. 
Medigap and Medicare Advantage:
.
Medigap policies can help cover out-of-pocket costs for Part A, but not if you're on a Medicare Advantage plan. 
Options for Long-Term Care:
Medicaid:
You may be eligible for long-term care through Medicaid, which has different eligibility requirements and coverage. 
Private Long-Term Care Insurance:
Consider private insurance policies to help cover the costs of long-term care. 
Other Programs:
Explore other public and private programs that may offer financial assistance for skilled nursing facility costs, such as PACE programs.

Gary Henderson · Answer

As always, you should specify whether you have a Medicare advantage plan or Medicare supplement plan 
The Medicare advantage plan you're going to pay a certain amount everyday starting day 21 through 100 
With Medicare supplement plans, you pay nothing up to 100 days 
If you go into a nursing home that is not covered by Medicare other than normal medical coverage does not pay for long-term care. At that point you'll have to look at different options, possibly Medicaid. If your income is low cuz they will typically take your social security payment to pay part of the bill and the rest would probably come from Medicaid, they can only take half of your financial assets. If you're married, they cannot touch your house or a car. If you're married, it's a complex issue, not a simple one to explain

Meghan Blankenship · Answer

Medicare covers short-term rehab in a skilled nursing facility - but it does not cover long-term custodial care. If your needs shift from rehab to long-term care your coverage changes significantly. What Medicare covers first - If you enter a skilled nursing facility for rehab: Medicare Part A covers up to 100 days per benefit period. You must have had a qualifying hospital stay (at least 3 days inpatient) Coverage includes skilled care like physical therapy, wound care or IV medications.

Answered by Meghan Blankenship on November 15, 2025

Broker Licensed in FL, MD & OH

Answered by Meghan Blankenship Medicare Insurance Agent

Suzanne Lamperti · Answer

You MUST have Part A and a qualifying  impatient hospital stay. This is covered for a short period of time. Medicare does NOT cover long term care. You should consider long term care insurance.

Marcie Barnes · Answer

Long term care is not covered by Medicare.

2 things you need to think about when it comes to long term care.

1.  Buy a long term care policy.  Depending on your age it could be quite expensive, but worth looking into 

2. If Long term care is needed.  Liquidation of all your assets and apply for Medicaid once you have exhausted all your resources.

Deborah Webster · Answer

Medicare will only cover 100 continuous days in Skilled nursing. If you are in a skilled nursing facility longer than 100 days, you would need a long-term care plan to kick in to pay for any additional days. Typically, you would be spent down to Medicaid (state insurance) if you have no long-term care insurance.

Answered by Deborah Webster on September 23, 2025

Broker Licensed in Ia & SC

Answered by Deborah Webster Medicare Insurance Agent

Carol Conner · Answer

Well for one thing Medicare does not cover long-term so you will either need to have some type of pension or 401(k) savings so you can afford that or get a policy that will cover that so you won’t have to spend down your heart earned money that you’ve worked for for so long, so talking to the local agent as myself and then Mckinney area I could help you with that

Answered by Carol Conner on November 23, 2025

Broker Licensed in TX

Answered by Carol Conner Medicare Insurance Agent

Linda Davies · Answer

Medicare and most health insurance, including Medicare Supplement Insurance (Medigap), don’t pay for long-term care. This type of 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 isn’t medical care. Instead, most long-term care helps with basic personal tasks of everyday life, sometimes called “activities of daily living.” This may include:

Help with personal care assistance (like dressing, bathing, and using the bathroom)
Home-delivered meals
Adult day health care
You might qualify for long-term care through Medicaid, or you can choose to buy private long-term care insurance.

You can get non-medical long-term care services at home, in the community, in an assisted living facility, or in a nursing home. It’s important to start planning for non-medical long-term care now to maintain your independence and make sure you get the care you may need, in the setting you want, now and in the future. If you’re an American Indian or Alaska Native, contact your local Indian health care provider for more information.

Ken Banks · Answer

Medicare coverage for your stay in a skilled nursing facility ends when your need for rehabilitative care stops. Long-term custodial care, which involves help with daily activities like bathing and dressing, is generally not covered by Medicare and is not considered rehabilitative. Your coverage will stop once the facility determines you have reached a point where you are not making progress, will not improve your condition, or are not participating in therapy. At that point, you are responsible for costs, which can be paid privately, or you may qualify for other programs like Medicaid.

Answered by Ken Banks on October 27, 2025

Broker Licensed in GA, AL, DC & 5 other states

Answered by Ken Banks Medicare Insurance Agent

William Murray · Answer

Medicare will cover your stay in a skilled nursing facility for rehab, after a medically necessary qualifying hospital stay.
Once the stay becomes non-medically necessary, Medicare coverage will not be extended for long-term care because long-term care is not a Medicare covered benefit.
You would have to pay out-of-pocket or have other long-term care insurance coverage.

Shahwali Hotaki · Answer

Medicare covers up to 100 days of skilled nursing care after a hospital stay—only for rehab, not long-term custodial care. If you need help with daily living beyond that, Medicare stops paying, and you’d need to pay out-of-pocket or apply for Medicaid.

Answered by Shahwali Hotaki on August 5, 2025

Agent Licensed in CA, CO, GA, IL & VA

Answered by Shahwali Hotaki Medicare Insurance Agent

Jermaine Williams · Answer

Nothing really happens to your Medicare advantage for the post part. You might be eligible for an Institutional Dual Eligible plan (if there's one available in your area). Otherwise, there are other solutions such as state Medicaid (if qualified) and other resources.

Answered by Jermaine Williams on September 2, 2025

Broker Licensed in TX, AL, AR & 12 other states

Answered by Jermaine Williams Medicare Insurance Agent

Angelina Watkins · Answer

Medicare will continue to cover medically necessary skilled services like physical or occupational therapy in a skilled nursing facility (SNF) for up to 100 days per benefit period. However, Medicare does not cover long-term custodial care, which includes help with daily living activities like bathing, dressing, or eating, so you will be responsible for 100% of the cost for this care once it is deemed the only care you need.

Answered by Angelina Watkins on November 1, 2025

Agent Licensed in OH, FL, GA & 5 other states

Answered by Angelina Watkins Medicare Insurance Agent

Rachael Metcalf · Answer

Nothing happens to your medicare coverage. Skilled Nursing has a limit of 100 days. Medicare does not cover long term care..... that is what a long-term care plan is for.

Ricky Gonzalez · Answer

Medicare will cover skilled nursing care for a limited time as long as you are improving and still require skilled services, but once your care becomes custodial or long-term, Medicare will no longer cover those costs. 

At that point, you would be responsible for paying privately, or you may qualify for Medicaid or long-term care insurance if you have it to help cover the extended stay.

Gabrielle Sones · Answer

Depending on your plan you should have a benefit for Skilled nursing facility and or home health care. I would speak to your carrier. I would also work with a broker to see what kind of additional protection you can add onto your coverage for these specific situations to help protect you more than what Medicare offers.

Answered by Gabrielle Sones on May 13, 2025

Broker Licensed in TX, AZ, FL & 7 other states

Answered by Gabrielle Sones Medicare Insurance Agent

Nicolas Cain · Answer

Medicare covers skilled nursing facility (SNF) rehab for up to 100 days if you meet certain criteria (like a prior 3-day hospital stay). But it does not cover long-term custodial care in a nursing home.

If you need long-term care after rehab, you’ll likely need to pay out-of-pocket, use Medicaid (if eligible), or consider long-term care insurance. Which we can also help you with!

Travis Helms · Answer

It will depend on the type of coverage you have. Medicare allows you 21 days in a rehab facility as long as you follow 3 rules. 
1. Medicare-approved facility 
2. Staying 3 midnights admitted as an inpatient.
3. Showing daily improvement every day you're in rehab.
At any time, days 1-20 you stop showing impatient, you will get charged for the time there.

If you would like help to navigate this or see options to help with this coverage, please contact me.

Charles Wimmer · Answer

It is according to m any variables such as whether you are a SNP, (special needs ) or on a dual plan of Medicare//Medicaid.

Dismery Gonzalez · Answer

Medicare will cover your  siklled nursing facility stay for short-term rehab if you qualify. It does not pay for long-term custodial.

Michael Pane · Answer

If you have either Original Medicare or Medicare Advantage plan, the first 20 days of being in a Skilled Nursing Facility will not have a co-pay or co-insurance.
After days 21-100, you will have a co-pay on Original Medicare of $217/day.
Medicare Advantage plans are similar to this cost also.

If you have a Medicare Supplement (or known as Medigap), different plan letters will cover days 21-100 in full.

After 100 days, you are responsible for full cost-share. If your skilled nursing facility stay requires you to move to a long-term care facility, Medicare DOES NOT cover long-term care. Usually, that will fall under private pay or your state's institutional Medicaid qualifications to pay for long-term care.

Jim Towle · Answer

If you enter a skilled nursing facility (SNF) for rehabilitation but then need long-term care, your Medicare coverage will change depending on the type and duration of care you require. Here’s what happens step by step:

1. Medicare Coverage for Skilled Nursing Facility (SNF) Care (Rehabilitation)
When you first enter a skilled nursing facility for rehabilitation following a hospital stay, Medicare Part A (hospital insurance) will typically cover your care under certain conditions. For Medicare to cover SNF care:

You must have been hospitalized for at least three consecutive days before being admitted to the skilled nursing facility.

Your doctor must certify that you need skilled nursing care (e.g., physical therapy, occupational therapy, or other skilled services) on a daily basis to improve or maintain your condition.

For the first 20 days, Medicare covers the full cost of your SNF care. After that, for days 21 through 100, you are responsible for a daily coinsurance (which in 2025 is $200 per day), and Medicare will cover the rest. Beyond 100 days, Medicare will no longer cover the cost of your care in the SNF, and you will be responsible for the full cost.

2. Transitioning from Short-Term Rehab to Long-Term Care
If you enter the SNF for rehabilitation, but during that time it becomes clear that you need long-term care (e.g., assistance with daily activities such as bathing, dressing, or eating), Medicare will stop covering your care after the 100-day limit if you continue to stay at the facility. Medicare is designed to cover only short-term, medically necessary rehabilitation, not long-term custodial care.

For long-term care, you’ll need to explore other payment options:

2.1. Medicaid
Medicare does not cover long-term care for individuals who need it for an extended period, but Medicaid may be available for those who qualify based on their financial situation. Medicaid provides coverage for long-term care in a skilled nursing facility.

Robert Silva · Answer

Sad to say, but Medicare doesn't pay for long-term care.  It will only pay while there is a prognosis for improvement.  

If you are planning ahead, you should talk with this with your financial planner as there are a variety of products that you can purchase the cover long term care.  In particular, there is long-term care insurance, life insurance policies with a long term care rider, and annuities that pay for long term care.  These options are far easier to do for young people for obvious reasons.  

If you need long term care now, but cannot afford it, Medicaid covers long term care. You have to qualify for it on the basis of limited financial resources.   You will likely need to spend down your assets before Medicaid pick it ups.  Be aware, though, that the State will look to your estate after you pass to get reimbursed.   I suggest talking to a trusted financial planner that knows about and has experience on this topic so that he or she can help you make a plan for you.

Keith McCarthy · Answer

Good question - this is a difficult question that many seniors may face. Generally speaking, Medicare does not cover long-term care. 

If specific medical coverage is needed, Medicare should cover that - but long-term care is a separate expense. 

Separate insurance exists for long-term care, and it is quite expensive. In fact, if you're already in need of long-term care, probably no insurer will cover that. The possibility of long-term care is something that all people need to consider in planning for the future.

Shawnette Henry · Answer

Continue to pay your premiums and you will continue to have your benefits. As it relates to the Skilled Nursing Facility (SNF) and Long Term Care (LTC), Medicare Advantage plans will pay for the first 20 days, you will be required to pay a coinsurance for days 21-100. If you have a Medigap/Supplement plan it will more likely cover up to day 100, after which your expenses are out of pocket. Depending on your income, you may qualify for Medicaid, you can also consider getting a long term care plan.

Answered by Shawnette Henry on October 30, 2025

Agent Licensed in NY

Answered by Shawnette Henry Medicare Insurance Agent

What happens to my Medicare coverage if I enter a skilled nursing facility for rehab but then need long-term care?

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