Medicare Supplement Skilled Nursing Facility Coverage: What Medigap Plans Pay for Rehab 2026

A skilled nursing facility (SNF) stay after surgery, stroke, or serious illness can be one of the most expensive episodes in a Medicare beneficiary’s life. Medicare Part A covers up to 100 days of SNF care per benefit period — but only the first 20 days are free. Days 21 through 100 carry a coinsurance of $209.50 per day in 2026, adding up to $16,760 for a maximum-length stay. The right Medigap plan eliminates this cost entirely, but choosing the wrong plan leaves you exposed.

How Medicare Covers Skilled Nursing Facility Care

Before understanding how Medigap helps, it’s important to know exactly what Original Medicare (Part A) pays for SNF care — and what it doesn’t.

Medicare Part A SNF Benefit Structure (2026)

SNF Stay Period	What Medicare Pays	What You Pay
Days 1-20	100% of approved amount	$0
Days 21-100	Approved amount minus coinsurance	$209.50/day
Day 101+	$0 (benefit exhausted)	100% of all costs

This means the maximum out-of-pocket coinsurance for a single SNF benefit period is:

80 days × $209.50 = $16,760

Who Needs SNF Care?

Skilled nursing facility care is not the same as long-term custodial nursing home care. Medicare only covers SNF stays when you need skilled services such as:

• Physical therapy after joint replacement, fracture, or stroke
• Occupational therapy to regain daily living skills
• Speech-language pathology after stroke or neurological events
• Intravenous (IV) therapy or injections requiring professional administration
• Wound care requiring skilled nursing
• Respiratory therapy or ventilator management
• Rehabilitation monitoring by licensed medical professionals

Medicare does not cover SNF stays for custodial care alone (help with bathing, dressing, eating) when no skilled services are needed.

Qualifying for Medicare SNF Coverage

Medicare sets strict requirements for SNF coverage. You must meet all four conditions:

1. 3-day inpatient hospital stay: You must be formally admitted as an inpatient for at least 3 consecutive days (not counting the day of discharge). Observation status does not count.

2. Admitted to SNF within 30 days: You must enter a Medicare-certified skilled nursing facility within 30 days of leaving the hospital.

3. Need for skilled services: Your condition must require skilled nursing or rehabilitative services that can only be provided in a SNF setting.

4. Doctor’s certification: Your doctor must certify that you need daily skilled care.

⚠️ The Observation Status Trap: Many hospitals place patients on “observation status” rather than formally admitting them as inpatients. If you’re on observation status, those days don’t count toward the 3-day requirement, and Medicare may deny your SNF coverage entirely. Always ask your hospital: “Am I admitted as an inpatient?”

Which Medigap Plans Cover SNF Coinsurance

Not all Medigap plans are equal when it comes to skilled nursing facility coverage. Here’s the complete breakdown of how each standardized plan handles SNF coinsurance for days 21-100:

Complete SNF Coverage by Medigap Plan (2026)

Medigap Plan	SNF Coinsurance Coverage	Your Cost (Days 21-100)	Max Annual SNF Exposure
Plan A	❌ None	$209.50/day	$16,760
Plan B	❌ None	$209.50/day	$16,760
Plan C	✅ 100%	$0/day	$0
Plan D	✅ 100%	$0/day	$0
Plan F	✅ 100%	$0/day	$0
Plan G	✅ 100%	$0/day	$0
Plan K	🟡 50%	$104.75/day	$8,380
Plan L	🟡 75%	$52.38/day	$4,190
Plan M	✅ 100%	$0/day	$0
Plan N	✅ 100%	$0/day	$0

Full SNF Coverage (Plans C, D, F, G, M, N)

These six plans cover 100% of Medicare’s SNF coinsurance for days 21-100. With any of these plans, your only cost for an SNF stay during the Medicare-covered period is $0.

Plan G is the standout choice for new Medicare beneficiaries because:

• It covers SNF coinsurance 100% (same as Plan F)
• It’s available to everyone (unlike Plan F, which is closed to new enrollees since 2020)
• Premiums are typically lower than Plan C or Plan D
• It also covers Part B excess charges (unlike Plans C, D, M, N)

For a detailed look at Plan G’s full benefits, see our guide to dropping Plan F and switching to Plan G.

Partial SNF Coverage (Plans K and L)

Plan K and Plan L use a cost-sharing model where they pay a percentage of covered services:

• Plan K covers 50% of SNF coinsurance: You pay $104.75/day for days 21-100
• Plan L covers 75% of SNF coinsurance: You pay $52.38/day for days 21-100

Both plans have an annual out-of-pocket limit ($7,220 for Plan K, $3,610 for Plan L in 2026). Once you hit this limit, the plan pays 100% of covered services for the rest of the year.

No SNF Coverage (Plans A and B)

Plans A and B are the only Medigap plans that do not cover SNF coinsurance at all. If you have Plan A or Plan B and need a 60-day SNF stay, you pay the full $209.50/day for days 21-60.

For help choosing the right plan based on your health profile, see our best Medigap plans by health profile guide.

Real Cost Examples: SNF Stays with Different Medigap Plans

Let’s look at what you’d actually pay for three common SNF stay lengths in 2026.

30-Day SNF Rehab Stay (e.g., hip replacement recovery)

Plan	Days 1-20	Days 21-30 (10 days)	Total SNF Cost to You
Plan A or B	$0	$2,095	$2,095
Plan K	$0	$1,047.50	$1,047.50
Plan L	$0	$523.80	$523.80
Plan C, D, F, G, M, N	$0	$0	$0

60-Day SNF Rehab Stay (e.g., stroke rehabilitation)

Plan	Days 1-20	Days 21-60 (40 days)	Total SNF Cost to You
Plan A or B	$0	$8,380	$8,380
Plan K	$0	$4,190	$4,190
Plan L	$0	$2,095	$2,095
Plan C, D, F, G, M, N	$0	$0	$0

100-Day SNF Rehab Stay (maximum benefit)

Plan	Days 1-20	Days 21-100 (80 days)	Total SNF Cost to You
Plan A or B	$0	$16,760	$16,760
Plan K	$0	$8,380	$8,380
Plan L	$0	$4,190	$4,190
Plan C, D, F, G, M, N	$0	$0	$0

A 100-day SNF stay is not unusual for serious conditions. A stroke patient might need 3-4 months of intensive physical and occupational therapy. Hip fracture patients often need 4-8 weeks of rehab. For anyone at risk of extended SNF stays, Plans A and B represent significant financial exposure.

Plan G vs Plan F: SNF Coverage Comparison

Since Plan F is no longer available to new Medicare beneficiaries (those who turned 65 after January 1, 2020), many people wonder if they’re missing out on SNF coverage by choosing Plan G.

Benefit	Plan F	Plan G
Part A coinsurance + 365 extra days	✅	✅
Part B coinsurance/copayment	✅	✅
Blood (first 3 pints)	✅	✅
Part A deductible ($1,676)	✅	✅
SNF coinsurance (days 21-100)	✅	✅
Part B deductible ($257)	✅	❌
Part B excess charges	✅	✅
Foreign travel emergency	✅	✅

For a deeper comparison of Medigap versus Medicare Advantage costs including SNF scenarios, see our Medigap vs Medicare Advantage cost comparison.

What Happens After Day 100

Medicare’s SNF benefit covers a maximum of 100 days per benefit period. After day 100, the financial picture changes dramatically:

No Medigap Plan Covers Day 101+

No Medigap plan — not even Plan F — covers SNF costs beyond Medicare’s 100-day benefit. Once you exhaust your 100 days, you’re responsible for the full cost of nursing facility care, which can range from:

• $250-$400/day for a semi-private room in a skilled nursing facility
• $300-$500/day for a private room
• $7,500-$15,000+/month for ongoing care

How Your Benefit Period Resets

Your 100-day SNF benefit resets when a new benefit period begins. A new benefit period starts when:

1. You have not received any inpatient hospital or SNF care for 60 consecutive days
2. You then have a new 3-day inpatient hospital stay
3. You are admitted to a SNF within 30 days of that hospital discharge

If you stop receiving skilled care for 30+ consecutive days, your current benefit period ends, but a new 100-day period requires the full qualification process again.

Planning for Long-Term Care Needs

Since Medigap doesn’t cover custodial care or stays beyond 100 days, consider these options for extended coverage:

• Long-term care insurance: Covers custodial care in SNFs, assisted living, and home health settings
• Hybrid life/LTC policies: Life insurance with a long-term care rider
• Medicaid: For those who meet income and asset requirements (typically after spending down assets)
• Self-insuring: Using savings and investments to pay for extended care

Medigap vs Medicare Advantage for SNF Coverage

If you’re deciding between Medigap and Medicare Advantage, SNF coverage is an important factor. Here’s how they compare:

Feature	Medigap (Plan G)	Medicare Advantage
SNF days 1-20	$0	Varies (often $0)
SNF days 21-100	$0 (covered by Plan G)	Varies ($0-$200+/day)
Network restriction	None — any Medicare-certified SNF	Usually in-network only
Prior authorization	Not required	Often required
100-day limit	Same (Medicare rule)	Same (Medicare rule)
Facility choice	Any Medicare-certified facility	Limited to network

Key Advantage of Medigap for SNF

The biggest advantage of Medigap for SNF stays is unrestricted facility choice. With Medigap, you can go to any Medicare-certified skilled nursing facility in the country. With Medicare Advantage, you’re typically limited to in-network facilities, which may not include the highest-rated rehab centers in your area.

For patients who want to choose a specialized rehab facility — such as one with a dedicated stroke unit or advanced physical therapy equipment — Medigap provides freedom that Medicare Advantage may not.

If you’re considering switching from Medicare Advantage to Medigap, see our Medicare Advantage to Medigap switching cost guide.

Common SNF Coverage Mistakes to Avoid

1. Assuming Observation Days Count Toward the 3-Day Rule

This is the single most common reason SNF coverage is denied. If the hospital places you on observation status (outpatient) rather than admitting you as an inpatient, those days do not count toward the 3-day qualifying stay.

What to do: Ask your doctor and the hospital’s case manager daily: “Am I admitted as an inpatient?” Request the “Medicare Important Message from Medicare” notice, which states your admission status.

2. Choosing Plan A or B to Save on Premiums

Plans A and B have the lowest premiums, but they leave you exposed to $16,760 in SNF coinsurance. For many beneficiaries, the premium savings are dwarfed by a single SNF stay.

Example: Plan A might save you $40/month compared to Plan G ($480/year). One 30-day SNF stay costs $2,095 with Plan A versus $0 with Plan G. It takes over 4 years of premium savings to cover the cost of a single short rehab stay.

3. Not Confirming SNF Certification

Even with the right Medigap plan, Medicare only pays for care at Medicare-certified skilled nursing facilities. Not all nursing homes are certified. Before admission, confirm the facility accepts Medicare patients and is certified.

4. Confusing SNF Care with Custodial Care

Medicare covers SNF care only when you need skilled services. If your condition improves to the point where you only need custodial care (help with activities of daily living), Medicare may stop covering the stay — even before day 100.

State-Specific SNF Considerations

Birthday Rule States

Several states offer a “birthday rule” that allows you to switch Medigap plans each year with guaranteed issue (no medical underwriting):

• California: Switch to an equal or lesser-benefit plan within 60 days of your birthday
• Oregon: Switch to an equal or lesser-benefit plan within 60 days of your birthday
• Missouri: Switch to a plan of equal or lesser benefit within 60 days of your birthday

This means if you have Plan A or B and are approaching a planned surgery, you could switch to Plan G during your birthday window to get full SNF coverage.

Year-Round Guaranteed Issue States

• New York: All Medigap plans are available year-round with guaranteed issue (community-rated pricing)
• Connecticut: Continuous open enrollment with guaranteed issue for plans A, B, C, D, F, G, K, L, M, N
• Massachusetts: State-specific Medigap plans with different rules

High-Deductible Plan G Considerations

High-Deductible Plan G (HDG) provides the same benefits as standard Plan G — including full SNF coinsurance coverage — but you must first meet a deductible ($2,800 in 2026). Once the deductible is met, HDG covers SNF coinsurance just like standard Plan G.

For detailed plan comparisons and premium break-even analysis, see our Plan N copay break-even analysis.

SNF Coverage Action Checklist

Before you need skilled nursing facility care, take these steps:

1. Check your Medigap plan: If you have Plans A or B, consider switching to Plan G for full SNF coverage
2. Verify your plan’s SNF benefit: Confirm your plan covers SNF coinsurance at 100%
3. Know your hospital admission status: If hospitalized, confirm you’re an inpatient (not observation)
4. Research SNF facilities in advance: Find Medicare-certified facilities with good ratings in your area
5. Understand the 100-day limit: No Medigap plan covers beyond day 100 — plan for long-term care separately
6. Keep documentation: Maintain records of hospital admissions and SNF stays for benefit period tracking

Frequently Asked Questions About Medigap and Skilled Nursing Facility Coverage

Which Medigap plans cover Skilled Nursing Facility coinsurance for rehab days 21-100?

Medigap Plans C, D, F, G, M, and N cover 100% of the SNF coinsurance ($209.50/day in 2026) for days 21-100. Plan K covers 50% ($104.75/day), and Plan L covers 75% ($157.13/day). Only Plans A and B do not cover SNF coinsurance at all.

How much does a 100-day skilled nursing facility rehab stay cost with Medigap Plan G?

With Medigap Plan G, your 100-day SNF rehab stay costs $0 out of pocket for SNF coinsurance. Plan G covers the full $209.50/day coinsurance for days 21-100, just like Plan F. Days 1-20 are covered by Medicare Part A at $0 coinsurance regardless of which Medigap plan you have.

What are the Medicare requirements to qualify for skilled nursing facility rehab coverage?

You must meet all four requirements: (1) Have a 3-day minimum inpatient hospital stay (observation days don’t count), (2) Be admitted to a Medicare-certified SNF within 30 days of hospital discharge, (3) Need skilled nursing or rehabilitation services that can only be provided in a SNF setting, (4) Your doctor must certify that you need daily skilled care. Missing any requirement means Medicare won’t cover the SNF stay.

Does Medigap cover skilled nursing facility costs after Medicare’s 100-day limit?

No. No Medigap plan covers SNF costs beyond Medicare’s 100-day benefit period. After day 100, you are responsible for 100% of nursing facility costs. For continued long-term care, you would need to use personal savings, long-term care insurance, or qualify for Medicaid.

Can I switch Medigap plans to get better skilled nursing facility coverage before a planned rehab stay?

You can apply to switch Medigap plans at any time, but outside your Medigap Open Enrollment Period or a guaranteed issue right, insurers can require medical underwriting. If you currently have Plan A or B (which don’t cover SNF coinsurance) and want Plan G (which covers it fully), your application could be denied based on health conditions. Some states offer birthday rules or year-round guaranteed issue switching.

How does skilled nursing facility coverage differ between Medigap and Medicare Advantage?

Medigap plans with SNF coverage (like Plan G) pay the full coinsurance for days 21-100 with no network restrictions at any Medicare-certified facility. Medicare Advantage plans may charge a daily copay (often $0 for first 20 days, then $200-$250/day) and typically require you to use in-network SNF facilities. Medigap offers more facility choice; Medicare Advantage may have lower or no coinsurance but limits your options.

Does the 3-day hospital stay rule for SNF rehab coverage still apply in 2026?

Yes. As of 2026, Original Medicare still requires a 3-day inpatient hospital stay before qualifying for SNF coverage. Observation status days do not count toward the 3-day requirement, which is a common reason beneficiaries are denied SNF coverage. Always confirm with your hospital that you are admitted as an inpatient, not under observation.

What happens if my skilled nursing facility rehab is interrupted — do I lose my 100-day SNF benefit?

If you stop receiving skilled care for 30 or more consecutive days, your benefit period ends and your 100-day SNF clock resets. A new benefit period (and new 100-day allowance) begins only after you have another 3-day inpatient hospital stay. Brief gaps of less than 30 days do not reset your benefit period.

---

Take Control of Your SNF Coverage

Skilled nursing facility rehab is one of the most financially devastating Medicare gaps for the unprepared. A single extended SNF stay can cost over $16,000 without the right Medigap plan — yet the solution is straightforward.

If you have Plan G (or Plans C, D, F, M, N): Your SNF coinsurance is fully covered. Days 1-100 cost $0 in coinsurance. You’re protected.

If you have Plan A or B: You’re exposed to the full $209.50/day coinsurance. Consider switching to Plan G during your next enrollment window.

If you’re choosing a plan for the first time: Plan G is the best value for most beneficiaries — it covers SNF coinsurance 100%, Part B excess charges, and the Part A deductible, all at a lower premium than Plan F.

Don’t wait until you’re facing a hospital stay to think about SNF coverage. The time to protect yourself is before you need it.

Related reads

• Medicare Supplement Plan N vs Plan G: Total Cost Comparison 2026

  Compare Medicare Supplement Plan N vs Plan G total costs including premiums, copays, and out-of-pocket expenses in 2026. Find which plan saves more.

• Medigap for Widows and Widowers: How Losing Spouse Coverage Affects Your Medicare Supplement in 2026

  Lost your spouse? Learn how widowhood affects your Medicare Supplement coverage, guaranteed issue rights, and enrollment windows. Step-by-step guide to getting Medigap after losing spouse coverage in 2026.

• Medigap and the 2026 Medicare Part D $2,000 Out-of-Pocket Cap: How It Changes Your Supplement Strategy

  The Medicare Part D $2,000 out-of-pocket cap is now in effect. Learn how this landmark change impacts your Medigap plan choice, whether Plan G is still worth it, and how to recalculate your total healthcare costs in 2026.