In short
Original Medicare covers skilled nursing facility care only after a qualifying inpatient hospital stay of at least three consecutive days, not counting the day of discharge. Time as an outpatient under observation does not count. Your parent must also enter a Medicare-certified SNF within 30 days of leaving the hospital and need daily skilled care.
The conditions, in full
Medicare SNF coverage
- Part A
- Your parent has Medicare Part A and days left in the benefit period
- Qualifying stay
- At least 3 consecutive inpatient days; the discharge day doesn't count
- Timing
- Admission to the SNF within 30 days of leaving the hospital
- Facility
- A Medicare-certified skilled nursing facility
- Need
- Skilled nursing or therapy that is medically necessary
How to count the days
Inpatient time starts when the doctor writes an order to admit. Medicare.gov's example: a patient who comes to the ER, spends one night in observation and is admitted on the second day was an outpatient for that first night. If your parent arrives Monday, is admitted Tuesday and leaves Friday, the inpatient days are Tuesday, Wednesday and Thursday. Friday is the discharge day.
What your parent pays in 2026
^ Original Medicare SNF costs per benefit period, 2026
| Days | Your parent pays |
|---|---|
| --- | --- |
| 1 to 20 | $0 per day, after the Part A deductible ($1,736) |
| 21 to 100 | $217 per day |
| 101 and after | All costs |
Some Medigap policies pay all or part of the day 21 to 100 coinsurance. Medicare Advantage plans set their own rules and costs, so check with the plan.
If the stay doesn't qualify
Ask the hospital, before discharge, whether your parent was an inpatient and for how many days. If the stay won't qualify, ask about home health, which has no hospital-stay requirement, or how a private-pay rehab stay would be billed.
Questions families ask
Does observation count toward the 3-day rule?
No. Observation is an outpatient service, so those hours and nights don't count, even in a regular hospital bed.
Does the day of discharge count?
No. Medicare counts consecutive inpatient days and does not count the discharge day.
Do Medicare Advantage plans use the 3-day rule?
Plans set their own coverage rules for skilled nursing. Ask the plan directly before discharge.
Is there a time limit for going to the SNF?
Yes. Medicare's SNF booklet says your parent must be admitted within 30 days of hospital discharge.