Does Medicare pay for a nursing home?
Yes — for up to 100 days, with conditions you'll probably miss. Then nothing. Get the discharge questions right and you keep the benefit.
Medicare pays for nursing home care under one specific scenario: skilled nursing facility (SNF) care after a qualifying inpatient hospital stay. Get the conditions wrong and Medicare pays zero — and you find out at discharge.
The four conditions, in order:
- Three midnights as an inpatient. Not "observation." This trips up thousands of families every year. If the hospital marked your parent as "observation status" — even for three full days — Medicare will not pay for the SNF stay that follows.
- Admission to a Medicare-certified SNF within 30 days of leaving the hospital.
- Medical need for daily skilled care — physical therapy, IV antibiotics, wound care. Not just "needs help."
- Continued progress. If therapy plateaus, Medicare can cut coverage early.
If all four are met: Medicare covers days 1–20 in full. Days 21–100 cost the patient about $210 per day in 2025. Day 101 onward: nothing from Medicare.
The questions that protect the benefit, asked of the hospital case manager — in writing — before discharge:
- Is this stay being billed as inpatient or observation?
- How many SNF days does my parent have remaining in this benefit period?
- What date does the benefit period end?
- Which Medicare-certified SNFs in this area have open beds today?
Long-term nursing home stays — months or years — are paid by some combination of out-of-pocket spending, long-term care insurance, Medicaid (after spend-down), or VA benefits. Medicare's 100 days are a bridge, not a destination.
The most expensive mistake families make: assuming the 100-day benefit window resets. It doesn't, until the patient has been out of inpatient skilled care for 60 consecutive days. Hospital readmission inside that window means picking up where the last benefit left off — sometimes with zero days remaining.