Myth:
“Medicare will pay for up to 100 days of rehab every year—automatically.”
Truth:
Medicare may cover up to 100 days of rehab per benefit period, but only if specific conditions are met. Many people are surprised to find that coverage stops sooner—or doesn’t apply at all—depending on the situation.
Bottom Line:
Don’t assume you’ll get 100 days of paid rehab just because you have Medicare. The full 100 days isn’t guaranteed, and many seniors face out-of-pocket costs much earlier than expected. Understanding the rules ahead of time can help you plan better and avoid unexpected bills.
Key Facts About What Medicare Covers:
Medicare Part A may cover up to 100 days of skilled nursing facility (SNF) care per benefit period, but only if:
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You had a qualifying 3-night hospital stay (not observation status)
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You need daily skilled care (like physical therapy, wound care, or IV medications)
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You’re admitted to the SNF within 30 days of your hospital discharge
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Your condition is improving and you’re actively participating in rehab
Coverage Timeline:
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Days 1–20: Fully covered by Medicare
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Days 21–100: You’ll owe a daily coinsurance (over $200/day in 2025) unless you have supplemental insurance
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After day 100 or if you stop progressing: Coverage ends
Common Pitfalls:
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Hospital stays for observation (not admission) don’t qualify
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If rehab plateaus or isn’t deemed medically necessary, coverage may end early
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You don’t get “a fresh 100 days” every calendar year—it’s based on benefit periods, which reset after 60 days without SNF/hospital care
Planning Ahead:
Understanding your coverage can help you:
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Avoid costly surprises
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Explore options like Medigap, Medicare Advantage, or long-term care insurance
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Know when to ask about appeals or care planning alternatives
Final Thought:
Medicare rehab coverage isn’t a “free 100-day pass.” Ask the right questions before a hospital discharge, and make sure your loved one meets the conditions for skilled nursing coverage. Being informed can save thousands—and reduce stress when it matters most.