What Medicare covers: skilled care after a hospital stay
Medicare Part A covers care in a Medicare-certified skilled nursing facility (SNF) when all of these are true:
- You had a qualifying inpatient hospital stay of at least three days in a row (counting the admission day, not the discharge day).
- You enter the SNF, usually within 30 days of leaving the hospital, for a condition treated in the hospital or that started while you were in the SNF.
- Your doctor says you need daily skilled care, such as nursing or therapy, that can only be given in a SNF.
| Days in a benefit period | You pay in 2026 (Original Medicare) |
|---|---|
| Days 1–20 | $0 |
| Days 21–100 | $217 per day |
| Days 101 and after | All costs |
Medicare Advantage plans must cover SNF care too, but their costs and rules (such as prior authorization or network facilities) differ; check your plan's Evidence of Coverage.
What Medicare doesn't cover: long-term custodial care
Medicare.gov says Medicare doesn't cover long-term care, also called custodial care, if that's the only care you need. Custodial care is help with daily activities such as bathing, dressing, eating and using the bathroom. Most nursing home care is custodial. Medicare still covers your doctor visits, hospital care and Part D drugs while you live in a nursing home.
How Ohio Medicaid pays for nursing homes
- Apply for Medicaid. Apply at benefits.ohio.gov or your county Department of Job and Family Services. Ohio Medicaid has income and asset rules; if your income is above Ohio's limit, a qualified income trust may be needed.
- Meet the level of care. You must need a nursing-facility level of care under Ohio's rule (OAC 5160-3-08).
- Pay your share. Residents generally put most of their income toward the cost of care each month, and Medicaid pays the rest.
- Know about estate recovery. Ohio can recover some Medicaid costs from the estates of people 55 and older. See does Ohio Medicaid take your house.
If you'd rather stay at home, Ohio's waiver programs pay for care at home or in assisted living for people who need a nursing-home level of care. See the PASSPORT waiver and MyCare Ohio. More in does Ohio Medicaid pay for nursing home care.
Choosing a nursing home in Ohio
Compare inspection results and staffing on Medicare's Care Compare. For local help and options, call 1-866-243-5678 to reach your area agency on aging. A licensed insurance agent who works with Benefits Life can explain how Medicare, Medigap and Medicare Advantage handle SNF stays, at no cost to you: you can request a call from a licensed insurance agent.
Related questions
Does Medicare cover assisted living in Ohio?
Ohio's Assisted Living Waiver.
Does Medicare cover home health care?
Skilled care at home.
What is the PASSPORT waiver?
Care at home instead of a nursing home.
Sources
- Medicare.gov — Skilled nursing facility care
- Medicare.gov — Long-term care
- Ohio Administrative Code — Rule 5160-3-08, Level of care
- Ohio Administrative Code — Rule 5160:1-2-07, Estate recovery
- Ohio Department of Aging — Regional long-term care ombudsman contacts
More questions in this guide
- Can I keep my doctor when I go on Medicare in Ohio?
- Does Medicare cover assisted living in Ohio?
- Does Medicare cover dental in Ohio?
- Does Medicare cover diabetes supplies in Ohio?
- Does Medicare cover eye exams and glasses in Ohio?
- Does Medicare cover hearing aids in Ohio?
- Does Medicare cover home health care in Ohio?
- Does Medicare cover mental health care in Ohio?
- How do I get rides to the doctor with Medicare in Ohio?
Part of the guide: Medicare basics for Ohioans · All questions
Frequently asked questions
What do I pay for a skilled nursing facility stay in 2026?
Under Original Medicare you pay nothing for days 1 to 20, $217 a day for days 21 to 100, and all costs after day 100 in a benefit period. Many Medigap plans pay the daily coinsurance for days 21 to 100.
Does time in the hospital under observation count toward the three days?
No. Medicare counts only days you were formally admitted as an inpatient, not days under observation, and not the day you leave. Ask the hospital whether you are an inpatient or an outpatient under observation.
Who helps if I have a problem with an Ohio nursing home?
Ohio's State Long-Term Care Ombudsman, part of the Ohio Department of Aging, advocates for residents of nursing homes and assisted living. Call 1-800-282-1206 to reach the program serving your area.
Medicare in your Ohio county
Plans, local agents and help, county by county: Franklin · Cuyahoga · Hamilton · Summit · Montgomery · Lucas · Butler · Stark · Lorain · Warren · Delaware · Lake · Mahoning · Clermont · Trumbull · Licking · Medina · Greene · Fairfield · Portage · All 88 counties →
