Does Medicare Cover Home Health Care?
Reviewed by Galit Sacajiu MD, MPH
Yes, Medicare covers home health care, but only under specific circumstances. Many people assume Medicare will cover whatever care they need at home. That assumption leads to real financial surprises when Medicare stops paying or refuses to cover a service.
What Medicare Covers for Home Health Care
Medicare Parts A and B both cover home health care services when four conditions are met. You must be homebound, meaning you have difficulty leaving your home without assistance and it requires considerable effort to do so. A doctor or other eligible provider must order the care. You must need skilled care, not just help with daily activities. And the home health agency must be Medicare-certified.
When those conditions are met, Medicare covers skilled nursing care on a part-time or intermittent basis, physical therapy, occupational therapy, speech-language pathology, medical social services, and some home health aide services when skilled nursing or therapy is also being provided.
There is no cost to you for covered home health services. Medicare pays 100%.
What Medicare Does Not Cover at Home
This is where many people run into trouble. Medicare does not cover custodial care. That means care that primarily helps with daily activities: bathing, dressing, eating, toileting, moving around the house. No matter how much you need that kind of help, if you do not also need skilled nursing or therapy, Medicare will not pay for it.
Medicare also does not cover 24-hour care at home, meals delivered to your home, homemaker services like cleaning and laundry, or personal care when it is the only care you need.
When Does Medicare Home Health Coverage Stop?
Medicare covers home health for as long as your doctor certifies that you need it and you continue to meet the eligibility criteria. Coverage is not limited to a fixed number of days. However, once you no longer need skilled care, or you no longer qualify as homebound, coverage ends.
This often catches people by surprise. Someone recovering from a hip replacement gets Medicare-covered home health visits. Once they improve enough to safely leave home, they are no longer homebound, and Medicare stops paying. If they still need some assistance at home, that cost falls to them.
What Happens After Medicare Stops Paying
Once Medicare home health coverage ends, families typically face three options. They can pay out of pocket for ongoing home care, which runs $25 to $40 per hour or more for a home health aide. Medicaid covers custodial home care for people who qualify financially. Or long-term care insurance covers it for people who purchased that coverage earlier.
Medicare Advantage plans sometimes offer limited home care benefits beyond what Original Medicare covers. Check your plan's supplemental benefits if you need ongoing support at home.
For a full overview of what Medicare excludes, see our [What Medicare Does Not Cover](/what-medicare-doesnt-cover) guide.