Does Medicare Cover Home Health Care?
When health issues make it harder to get around or recover independently, many seniors ask:
“Does Medicare cover home health care?”
The short answer is yes — but only under specific conditions.
Medicare does cover certain home health services, but the rules are strict, and misunderstandings often lead to denied services or unexpected costs. This guide explains what Medicare covers, what it doesn’t, and how to make sure you qualify.
What Is Considered Home Health Care Under Medicare?
Medicare defines home health care as medically necessary services provided in your home by licensed professionals.
Covered services are meant to:
Treat an illness or injury
Help with recovery after hospitalization or surgery
Manage chronic conditions under a care plan
This is not the same as long-term caregiving or help with daily living alone.
What Home Health Services Does Medicare Cover?
If you qualify, Medicare may cover:
Skilled nursing care (part-time or intermittent)
Physical therapy
Occupational therapy
Speech-language pathology services
Medical social services
Limited home health aide services (when tied to skilled care)
Durable medical equipment (DME), such as walkers or wheelchairs
These services are typically covered under Medicare Part A or Part B, depending on your situation.
📞 Unsure whether your situation qualifies?
Call Medicare Plan Assistance at (561) 808-9410 to review your home health eligibility before services begin.
Requirements to Qualify for Medicare Home Health Coverage
To receive Medicare-covered home health care, all of the following must usually apply:
1. You Must Be Under a Doctor’s Care
A doctor must:
Certify that you need home health services
Create and regularly review a care plan
2. You Must Be Homebound
“Homebound” does not mean you can never leave your house.
It generally means:
Leaving home requires considerable effort
You need assistance or medical equipment to leave
Trips outside the home are infrequent or for medical care
3. You Must Need Skilled Care
Medicare requires a need for:
Skilled nursing, or
Skilled therapy services
Home health aides alone do not qualify.
4. The Agency Must Be Medicare-Approved
Services must come from a Medicare-certified home health agency.
How Much Does Medicare Pay for Home Health Care?
If you meet the requirements:
Home health services are usually covered at 100%
There is typically no copay for covered services
Durable medical equipment may require coinsurance
This surprises many seniors — but only if coverage is set up correctly.
What Medicare Does NOT Cover at Home
Medicare does not cover:
24-hour care at home
Custodial care only (help with bathing, dressing, eating)
Homemaker services like cleaning or cooking
Personal care when no skilled care is required
Long-term home care
These are some of the most common sources of confusion.
📞 Not sure if the care you need is covered or not?
Call (561) 808-9410 to speak with Medicare Plan Assistance and get clarity before costs add up.
Does Medicare Advantage Cover Home Health Care?
Many Medicare Advantage (Part C) plans cover everything Original Medicare does — and some may offer additional home-based benefits, such as:
Expanded home health services
Post-hospital in-home support
Care coordination
Transportation or meal services (plan-specific)
Coverage varies by plan and county, so it’s important to review details carefully.
Common Mistakes Seniors Make With Home Health Care
❌ Assuming all home care is covered
❌ Starting services before approval
❌ Using a non-certified agency
❌ Confusing custodial care with skilled care
❌ Not reviewing Medicare Advantage benefits
These mistakes can lead to denied claims or out-of-pocket costs.
How Medicare Plan Assistance Helps With Home Health Coverage
Medicare Plan Assistance can help you:
Confirm whether you qualify for home health care
Understand what services are covered
Coordinate with Medicare-approved agencies
Review Medicare Advantage options with enhanced benefits
Avoid unnecessary costs or denials
Getting guidance before care starts is the key.
📞 Need help setting up home health care correctly?
Call Medicare Plan Assistance at (561) 808-9410 to review your options and protect your coverage.
Final Thoughts
Medicare does cover home health care — but only when specific conditions are met.
If you or a loved one needs care at home, understanding the rules ahead of time can:
Reduce stress
Prevent denied services
Save money
Ensure continuity of care
Get Help With Medicare Home Health Coverage Today
Before starting or changing home health services, talk with Medicare Plan Assistance to make sure everything is set up properly.
📞 Call (561) 808-9410 today to review your home health coverage and next steps.