The 3-day inpatient rule
Under Original Medicare, a skilled nursing facility (SNF) stay generally requires a qualifying 3-day inpatient hospital stay first. Those are midnights as an admitted inpatient. Time in observation, the emergency room, or outpatient status usually does not count, even if you spent the night. Ask the hospital: “Am I admitted as an inpatient?”
Days 1–20, 21–100, and after
If the SNF stay qualifies under Original Medicare in 2026, days 1–20 have $0 coinsurance. Days 21–100 have a daily coinsurance ($217 in 2026). After day 100 in a benefit period, Original Medicare SNF coverage ends unless a new benefit period starts. These figures are CMS amounts, not a facility’s private-pay rate.
What a benefit period is
A benefit period starts when you are admitted as an inpatient to a hospital or SNF. It ends when you have been out of both for 60 days in a row. A new qualifying hospital stay can start a new benefit period — and a new 100-day SNF clock. People are often surprised that a later stay can reopen the clock.
Medicare Advantage is different
A Medicare Advantage plan may require prior authorization, a contracted SNF, and different cost-sharing. Some products waive the 3-day inpatient rule. None of that is automatic. Ask the plan and the facility. This article sketches Original Medicare only.
Common questions
- Does a night in observation count toward the 3 days?
- Usually no, under Original Medicare. Inpatient admission is what counts. Ask the hospital for your status in writing.
- Is the $217 daily amount what I will pay?
- It is the 2026 Original Medicare coinsurance for SNF days 21–100 if the stay qualifies. Facility extra charges and Advantage cost-sharing can differ. This is not a bill.
Related topics
Worksheet
SNF 3-day stay and benefit period
Original Medicare skilled nursing: the 3-day inpatient rule, days 1–100, and 2026 coinsurance.