Medicare and rehab. It sounds simple until you’re sitting in a hospital room with a clipboard in your hand and a discharge planner hovering by the door. Honestly, the clock starts ticking faster than most people realize. If you’re wondering how long will Medicare pay for rehab, the answer isn't a single number. It’s a moving target that depends on where you are, why you’re there, and how fast you’re getting better.
There are two main "tracks" for rehab under Medicare. You’ve got the intensive version (Inpatient Rehabilitation Facilities or IRFs) and the slower-paced version (Skilled Nursing Facilities or SNFs).
They don't work the same way.
The 100-Day Clock: Skilled Nursing Facilities (SNF)
Most people end up here after a hip replacement or a bad fall. You might know it as "the nursing home," but for Medicare, it's a Skilled Nursing Facility.
Medicare Part A covers up to 100 days of rehab in an SNF per benefit period. But don’t get too comfortable with that 100-day number. It is a limit, not a guarantee.
Here is the breakdown of what you actually pay in 2026:
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- Days 1–20: You pay $0. Medicare covers everything.
- Days 21–100: You pay a daily coinsurance. For 2026, this has bumped up to $217 per day.
- Day 101 and beyond: You pay everything. The well runs dry.
There is a catch. To even get into this track, you must have a "qualifying hospital stay." That means you were a formal inpatient (not just "under observation") for at least three consecutive days. If you were only in the hospital for two days, Medicare usually won't pay a dime for the SNF rehab.
The Intensive Track: Inpatient Rehabilitation Facilities (IRF)
Sometimes you need something more "hardcore" than a nursing home. Maybe it’s a stroke or a spinal cord injury. This is where IRFs come in. They are often units inside a hospital or standalone rehab hospitals.
Medicare treats these stays more like a hospital stay than a nursing home stay. The timing is different.
Instead of a 100-day limit, you are working within a 90-day benefit period for inpatient care.
- Days 1–60: You pay $0 after you've hit your Part A deductible (which is **$1,736** in 2026). If you just came from the hospital, you likely already paid this deductible.
- Days 61–90: You pay $434 per day in 2026.
- Days 91 and beyond: These are "Lifetime Reserve Days." You get 60 of these in your entire life. In 2026, they cost $868 per day. Once they're gone, they're gone forever.
To stay in an IRF, you have to prove you can handle the "Three-Hour Rule." You must be able to participate in at least three hours of intensive therapy per day, five days a week. If you get too tired or can’t keep up, the facility might move you to a lower-level SNF.
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Why Medicare Might Stop Paying Early
This is where things get messy. Just because you have "days left" doesn't mean Medicare keeps paying.
Medicare pays for rehab based on medical necessity.
If a physical therapist decides you’ve reached a "plateau"—meaning you aren't really getting better anymore—they are required to give you a notice. It’s called a Notice of Non-Coverage. Essentially, it says, "We think you're done."
You can appeal this. People often do. But once the facility determines you no longer need "skilled" care and only need "custodial" care (help with bathing, eating, or walking), Medicare stops the clock. Medicare does not pay for long-term custodial care. Ever.
The "Benefit Period" Loophole
A benefit period isn't a calendar year. It starts the day you go into the hospital and ends when you haven't received any inpatient or SNF care for 60 days in a row.
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If you go to rehab, go home for 61 days, and then have another stroke, your 100-day clock resets. You get a brand-new 100 days. But you also have to pay a brand-new deductible.
What About Medicare Advantage?
If you have a private plan like an HMO or PPO (Medicare Part C), the rules change. These plans have to cover what Original Medicare covers, but they often require prior authorization.
In 2026, many Advantage plans are tightening their belts. They might only approve seven days of rehab at a time. Then the facility has to "ask" for more. This can lead to some stressful Friday afternoons where you're waiting to see if your stay is covered for next week.
Actionable Steps for Navigating Coverage
If you or a parent are heading into rehab, don't just wait for the bill. Do these three things immediately:
- Check the "Observation" Status: Before leaving the hospital, ask the social worker: "Was this a three-day inpatient stay or was it observation?" If it was observation, Medicare won't pay for the SNF.
- Request the Daily Notes: You have a right to see the therapy progress notes. If the therapist writes "patient unmotivated" or "no progress made," Medicare will use that to cut off funding. Make sure the patient is working hard during those sessions.
- Know the Appeal Process: If you get a notice that coverage is ending, you usually have until noon the next day to file an expedited appeal with the Quality Improvement Organization (QIO). It buys you a few extra days and a second pair of eyes on the medical records.
Medicare's rehab coverage is a safety net, not a long-term solution. It's designed to get you back on your feet—or at least stable enough to go home—not to provide a place to live indefinitely.