Does Medicare cover home health care?
Families ask this most often in the week after a hospital stay, and the answer depends on one word: skilled. Medicare pays for a nurse or therapist coming to the house; it doesn't pay for someone to help with the day.
Yes, within limits. Medicare Parts A and B cover home health care when four conditions are met: a doctor or other practitioner has certified after a face-to-face visit that you need it and set up a plan of care; you need part-time or intermittent skilled nursing care, physical therapy, occupational therapy or speech therapy; you're homebound (leaving home takes a major effort and is infrequent); and the agency is Medicare-certified. Covered services cost you $0; durable medical equipment ordered as part of the plan costs 20% after the Part B deductible. A home health aide for bathing and dressing is covered only while you're also getting skilled care. What Medicare never covers is custodial care: an aide for daily living on its own, 24-hour care, meals, housekeeping or shopping. That is long-term care, paid for by Medicaid, long-term care insurance or you.
The four conditions
- A doctor's certification and plan of care, after a face-to-face visit within 90 days before or 30 days after care starts. Nurse practitioners and physician assistants can certify too.
- A skilled need: part-time or intermittent skilled nursing, or physical, speech or continuing occupational therapy. "Skilled" means it takes a licensed nurse or therapist to do it safely: wound care, IV medication, injections, monitoring an unstable condition, therapy after a stroke or surgery.
- Homebound: leaving home is a considerable effort and happens infrequently, apart from medical care, religious services and short outings.
- A Medicare-certified home health agency. Under Original Medicare you can use any certified agency; under Advantage, usually an in-network one, often with prior authorization.
What it costs
- Home health services: $0. No deductible, no coinsurance, under Original Medicare. Advantage plans generally match this but check the Evidence of Coverage.
- Durable medical equipment: 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026); Medigap covers the 20%.
- Before care starts the agency must tell you in writing what Medicare will and won't pay for (an Advance Beneficiary Notice for anything outside the benefit).
Home health versus long-term care
Home health is medical care that happens to be delivered at home; it ends when the skilled need ends. Long-term care is help with living: an aide, adult day care, assisted living, a nursing home for custodial reasons. Medicare doesn't pay for long-term care, and this is the gap most Capital Region families discover at the worst time. The three ways it gets paid: New York Medicaid, for people who qualify on income and assets (the state's home-care look-back rule has been enacted but not yet implemented); long-term care insurance bought years earlier; or private funds. Medicare's skilled nursing facility benefit is the other piece people confuse with long-term care: up to 100 days of rehabilitation after a qualifying three-day hospital stay, with a daily coinsurance from day 21, and then nothing. See long-term care insurance and Medicare and Medicaid together.
How I help
I can't arrange care, but I can tell you what your plan pays and what it doesn't before you need it, compare Advantage plans on their home-health and skilled-nursing rules, and, for people in their fifties and sixties, show what long-term care coverage costs while it's still available. Ask.
- Home health services (Medicare.gov) — conditions; $0 for services; 20% for DME
- Medicare and home health care, publication 10969 (Medicare.gov, PDF)
- Long-term care (Medicare.gov) — custodial care not covered
Common questions
Short answers to what people ask before they call.
What does Medicare home health care include?
Part-time or intermittent skilled nursing (wound care, injections, monitoring a condition, teaching), physical, occupational and speech therapy, medical social services, a home health aide's personal care while you're receiving skilled care, and medical supplies. Services are $0; durable medical equipment such as a walker or hospital bed is 20% after the Part B deductible. Care is provided by a Medicare-certified home health agency under a doctor's plan of care, reviewed every 60 days.
What does 'homebound' mean?
You have trouble leaving home without help (a device, another person, or special transportation) because of illness or injury, or leaving isn't recommended, and leaving takes considerable effort. You can still be homebound if you go to medical appointments, religious services, adult day care, a barber, or occasional short outings.
Does Medicare pay for a home aide or 24-hour care?
No. Custodial care, meaning help with bathing, dressing, eating, toileting and getting around, is not covered when it's the only care you need, and neither are 24-hour care, meal delivery, housekeeping or shopping. Those are long-term care. In New York, Medicaid covers home care for people who qualify financially (with a look-back period for home care that has been enacted but repeatedly delayed); long-term care insurance covers it for people who bought a policy; otherwise it's paid privately.
Is there a limit on how long Medicare home health lasts?
There's no fixed number of visits or days as long as the conditions are still met; care is certified in 60-day episodes and recertified while you remain homebound and need skilled care. Skilled nursing must be part-time (generally under 8 hours a day and 28 hours a week, sometimes up to 35). Medicare Advantage plans cover the same benefit but may require prior authorization and use of in-network agencies.
Planning for care at home?
Medicare pays for skilled care at home, not for help with daily living. I'll show what your plan covers, what Medicaid and long-term care insurance add, and what to put in place before it's urgent.