What does medicare cover after a hospital stay?

After a qualifying hospital stay, Medicare may cover short-term skilled nursing care in a skilled nursing facility (SNF). Skilled nursing means round-the-clock care from licensed nurses, plus rehab such as physical, occupational, or speech therapy.

This is usually for recovery, not long-term custodial care. Custodial care means help with daily tasks like bathing, dressing, eating, or moving around when the main need is supervision and personal care.

In general, Medicare may cover up to 100 days in a SNF after a qualifying hospital stay, if the person still needs skilled care. Coverage rules are specific, and the exact coverage depends on the clinical and billing rules in place at the time.

Medicare usually does not pay for long-term nursing home care when the main need is personal care and supervision. It also does not pay for room and board in most long-term situations unless the care meets Medicare’s skilled-care rules.

Families are often surprised by this. A facility may look like a nursing home, but Medicare coverage depends on the type of care being given, not just the building.

If you are comparing options, it is wise to ask the facility which services are billed to Medicare, which are not, and what the family may owe after coverage ends.

For short-term skilled nursing care, Medicare may cover much of the early cost, but there can still be cost-sharing. A common rule is that after day 20, the person may begin paying a daily coinsurance amount if Medicare coverage continues. Exact amounts change over time.

If Medicare coverage ends, the family may need to pay privately or check whether Medicaid may help. Medicaid is different from Medicare. Medicaid may cover long-term nursing care for people who qualify based on income and assets, and the rules vary by state.

As a broad planning range, nursing-home or skilled-nursing care often costs about $7,000 to $13,000+ per month, but the real number depends on the state, the level of care, and whether the room is private or shared.

A Medicare nursing facility rating often refers to the CMS Five-Star rating. It has three parts: health inspections, staffing, and quality measures. Staffing is often the most telling part, especially RN hours per resident per day.

RN means registered nurse. Staffing ratio means how many residents each nurse or aide cares for. Lower staffing can make it harder for a facility to respond quickly and consistently.

You can review ratings on Medicare.gov Care Compare and then use them as one part of your decision, not the only part. Taking time to compare facilities is normal and wise.

When possible, ask about the Medicare coverage period, therapy schedule, discharge planning, and what happens when skilled coverage ends. Ask how the facility handles after-hours needs, wound care, and communication with family.

It also helps to ask whether the facility accepts the person’s expected payer after Medicare ends, such as private pay or Medicaid if the person qualifies. Medicare and Medicaid rules are separate. Immigration status does not control whether a person can ask questions, compare facilities, or get help understanding options.

If you want help comparing facilities, Northhaven Care is a free matching service, not a care provider. Some participating facilities pay us a flat fee to be matched. That never changes what the family pays, and it never affects our guidance about Medicare or Medicaid.

Choosing a nursing home for someone you love is hard, especially after a hospital stay. It is normal to compare more than one facility and to ask direct questions.

You can read our step-by-step guide on how to choose a nursing home or use our free matching help if you want a simpler starting point. If ratings are confusing, we also offer quality and ratings help.

For official coverage details, check Medicare.gov and your state’s Medicaid office. If you have concerns about care in a facility, your state’s long-term care ombudsman can help explain the next steps.