Many people assume that Medicare will fully cover their long-term care needs, but the reality is more complex—and potentially costly. One of the most misunderstood benefits is the 100-day coverage period for skilled nursing care under Medicare Part A.

In this article, we’ll break down what those 100 days mean, when the clock resets, and why it’s essential to plan ahead with Medicaid in mind.

What Does Medicare Part A Cover for Skilled Nursing?

Medicare Part A helps cover care in a skilled nursing facility (SNF), but only under specific conditions. You are eligible for up to 100 days of SNF care per benefit period after a qualifying hospital stay (at least three days). This includes services like physical therapy, wound care, and IV medications—care that requires professional skills and can’t be provided at home.

However, this benefit is not unlimited. Once you’ve used up your 100 covered days, Medicare stops paying—and unless you have supplemental insurance or qualify for Medicaid, you’ll be responsible for the cost.

Why Timing and Tracking Matter

Patients and families must be vigilant about tracking days of care and understanding the timeline. If a patient is discharged from a skilled nursing facility but is readmitted within 60 days due to a related or new medical issue, the Medicare benefit does not reset. The days continue to count from the original allotment, which can quickly result in exhausting the 100-day maximum.

If, however, the patient remains out of the hospital and does not require skilled nursing care for at least 60 days, the Medicare clock resets, and a new benefit period can begin. This timing becomes essential in planning future care needs and anticipating costs.

The concern for many families arises when the 100 days are used up, and Medicare no longer pays for skilled nursing care. At that point, the financial responsibility falls entirely on the patient and their family. The average cost of skilled nursing care can exceed $10,000 per month, making long-term care unaffordable for many without additional assistance.

Prepare for Medicaid Before It’s Too Late

When the Medicare benefit ends, families are often faced with a difficult decision: either pay out of pocket or attempt to qualify for Medicaid. However, Medicaid eligibility is based on strict income and asset limits. Without proper planning, individuals may be forced to spend down their life savings in order to qualify. This is why proactive Medicaid planning is so important.

Consulting with an elder law attorney well before the need arises allows families to explore legal and financial tools that can help protect assets while still enabling Medicaid eligibility. These strategies might include setting up irrevocable trusts, restructuring assets, or implementing other legal techniques to preserve wealth. Waiting until care is needed can significantly limit these options, and often results in higher costs and more stress for families.

Protect Your Legacy Through Long-Term Planning

Medicaid planning is not just about meeting eligibility requirements—it’s about protecting a lifetime of savings, preserving family legacies, and ensuring that individuals receive the care they need without financial devastation. By taking the time to plan early, families can avoid crisis-driven decisions and feel more confident in the future.

For anyone concerned about the limits of Medicare coverage or anticipating long-term care needs for themselves or a loved one, now is the time to act.. A conversation with an experienced elder law attorney can clarify your options and help you build a sustainable, protective plan for the years ahead.