How long will Medicare allow you to stay in rehab?

Medicare covers up to 100 days of skilled nursing facility (SNF) rehab or up to 90 days in an inpatient rehabilitation facility (IRF) per benefit period, depending on the type of facility and medical necessity.

Skilled Nursing Facility (SNF) Rehab

• Days 1–20: 100% covered by Medicare after you meet the Part A deductible ($0 out-of-pocket for daily care).
• Days 21–100: Medicare covers all costs except for a daily coinsurance amount ($217 per day in 2026).
• After 100 days: Medicare stops paying, and you pay all costs.
• Requirements: You must have a qualifying 3-consecutive-day inpatient hospital stay and need daily skilled care.

Inpatient Rehabilitation Facility (IRF)

• Days 1–60: Covered after you pay the Part A deductible ($1,736 in 2026), with $0 additional daily coinsurance.
• Days 61–90: You pay a daily coinsurance amount ($434 per day in 2026).
• Days 91–150: You pay a higher daily coinsurance ($868 per day in 2026) using your lifetime reserve days.
• After 150 days: You pay all costs.

Important Rules

• Coverage ends earlier than the maximum days if you stop improving or no longer need daily skilled therapy.
• A benefit period resets after you go 60 consecutive days without inpatient hospital or SNF care.

Medicare pays for up to 14 weeks (100 days) of skilled nursing facility rehabilitation per benefit period, and up to about 13 weeks (90 days) per benefit period in an inpatient rehabilitation hospital facility.

Skilled Nursing Facility (SNF) Rehab

• Duration: Up to 100 days (roughly 14 weeks) per benefit period.
• Cost (2026): Days 1–20 are fully covered ($0 coinsurance); days 21–100 require a daily coinsurance amount.
• Rules: You must have a prior inpatient hospital stay of at least three consecutive days before admission.

Inpatient Rehabilitation Facility (IRF)

• Duration: Up to 90 days (about 13 weeks) per benefit period, with an extra 60 lifetime reserve days available.
• Cost (2026): Days 1–60 have a $1,736 deductible with $0 additional daily cost; days 61–90 cost $434 per day.
• Rules: Requires intensive therapy (typically 3 hours a day, 5 days a week) and active physician supervision.

When Medicare rehab coverage ends, you must either transition to an alternative payment method, appeal the decision, or plan for discharge. Original Medicare covers up to 100 days in a skilled nursing facility per benefit period (100% for the first 20 days, with coinsurance for days 21–100), and stops entirely after day 100.

Immediate Steps to Take

• Review the Notice of Medicare Non-Coverage: The facility must give you this written notice before your coverage stops, explaining why your care is no longer covered.
• File a Fast Appeal: If you believe you still need skilled care and that coverage is ending prematurely, you can request an expedited appeal through your local Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) by noon of the day before coverage ends.
• Check Your Day Count: Contact the facility’s billing department to confirm exactly which day of your benefit period you are on and whether lifetime reserve days are available.

Options for Covering Continued Care

• Medigap (Medicare Supplement Insurance): If you have a standardized Medigap policy, it may cover out-of-pocket coinsurance costs for days 21–100 or extend inpatient coverage limits, though it will not pay for care in settings that Medicare does not recognize.
• Medicaid: If personal savings are depleted or if income and assets meet low-income thresholds, Medicaid can kick in to cover long-term or extended care. Many individuals qualify for dual eligibility without realizing it.
• Private Pay and Financing: You can pay out-of-pocket on a daily or monthly basis if extended recovery is required before returning home. Ask the facility about sliding-scale fees, nonprofit financial assistance, or custom payment plans.
• Transition to Home Health or Outpatient Therapy: If inpatient care is no longer medically necessary, transition safely by utilizing Medicare Part B for outpatient physical, occupational, or speech therapy.

Medicare or a private Medicare Advantage plan typically denies inpatient rehabilitation because it decides the care is not strictly "medically necessary" or believes the patient can recover safely at a lower, less expensive level of care.

Common Reasons for Denial

• Lower Level of Care: The insurance reviewer decides your needs can be met at home with home health care or in a skilled nursing facility (SNF) instead of an inpatient rehabilitation facility (IRF).
• Not Sick Enough (or Too Sick): The plan concludes your condition has improved enough for discharge, or conversely, that you are too medically unstable or weak to actively participate in and tolerate intensive daily therapy.
• Insufficient Documentation: The medical notes or physician letters do not clearly prove why you need intensive inpatient care rather than standard post-acute care.
• Lack of Prior Authorization: Private Medicare Advantage plans often require formal pre-approval before admitting a patient to inpatient rehab. Recent findings from the Department of Health and Human Services Office of Inspector General show that these private plans deny a high volume of post-acute care requests, though a large share of those initial denials get overturned on appeal.

What You Can Do

• Review the Notice: Read the official denial notice carefully to see the exact reason and deadline for filing an appeal.
• Gather Strong Evidence: Ask your doctor and physical or occupational therapists for detailed notes highlighting your specific functional limitations and fall risks.
• File an Appeal: Submit a fast appeal immediately through your hospital or insurance plan if you believe going home is unsafe.

Original Medicare does not cover routine dental care, routine eye exams and eyeglasses, hearing aids and fittings, long-term (custodial) care, and routine foot care.

Uncovered Treatments and Services

• Routine dental care: Cleanings, fillings, tooth extractions, root canals, and dentures are generally excluded.
• Routine vision care: Regular eye exams, prescription eyeglasses, and contact lenses are not paid for, though exceptions exist for conditions like cataracts or diabetes.
• Hearing aids: Routine hearing tests, hearing aid devices, and fittings are entirely out-of-pocket under Original Medicare.
• Long-term care: Ongoing assistance with daily living activities—such as bathing, dressing, and eating in a nursing home or at home—is not covered unless it is short-term skilled rehabilitation.
• Routine foot care: General foot maintenance like trimming toenails or removing corns and calluses is excluded, except for specific medical necessities related to diabetes.

For more details on exclusions, check the official Medicare Non-Covered Services Guide.