Full Definition

Coverage structure for 2024: Days 1-20 are covered at 100% (after the Part A deductible). Days 21-100 require a daily copayment of approximately $194.50, paid by the beneficiary (or their Medigap plan). Coverage ends at day 100 OR when daily skilled service is no longer needed, whichever comes first.

Key eligibility requirements: The hospital stay must be at least 3 consecutive days as an inpatient (not under observation status). The SNF must be Medicare-certified. The patient must need skilled nursing or skilled therapy services daily. Coverage ends when the skilled need ends — the day limit is a maximum, not a guaranteed coverage period.

For Medicare Advantage patients, the benefit structure is similar conceptually but the specific day limits, copayments, and prior authorization requirements are controlled by the individual plan. Initial MA authorizations for SNF stays are often 7-14 days with renewal requirements.