Medicare's 100-day skilled nursing benefit helps with short-term recovery, but it's often misunderstood. Here's how it actually works.
How does Medicare's 100-day skilled nursing benefit work?
After a qualifying inpatient hospital stay of at least three consecutive days (not counting the discharge day), Medicare Part A covers skilled nursing facility care for up to 100 days per benefit period. Medicare pays the full cost for days 1 through 20. For days 21 through 100, you owe a daily coinsurance — $209.50 per day in 2025. After day 100, Medicare pays nothing and you're responsible for all costs. Coverage requires that you need daily skilled care (like physical therapy or skilled nursing) that can only be provided in a facility. If you stop improving or no longer need skilled care, coverage can end before 100 days. Call 1-800-MEDIGAP (1-800-633-4427) for help.
How can I cover the days 21-100 coinsurance?
The daily coinsurance for days 21-100 adds up quickly — at $209.50 a day, the full stretch can exceed $16,000. A Medicare Supplement (Medigap) plan is the most common way to cover this. Most Medigap plans, including popular Plans G and N, pay the skilled nursing facility coinsurance in full, so you owe nothing for days 21-100. Medicare Advantage plans handle skilled nursing differently, often with their own daily copays. Knowing your coverage before you need it prevents a large surprise bill. A licensed agent can review your Medigap or Advantage coverage and explain exactly what you'd pay. Call 1-800-MEDIGAP for a free, no-pressure review.