Frequently Asked Questions
Does Medicare cover home health care?
Yes — Medicare Part A and Part B both cover home health care, but only if you meet specific eligibility criteria: you must be homebound, your doctor must certify a need for skilled care (skilled nursing, physical therapy, speech therapy, or occupational therapy), and your care must be provided by a Medicare-certified home health agency. There is no copay for covered home health services.
What does Medicare home health care cover?
Medicare covers skilled nursing care, physical therapy, speech-language pathology, occupational therapy, home health aide services (when skilled care is also needed), medical social services, and durable medical equipment used at home. It does not cover 24-hour home care, homemaker services, or personal care not related to medical treatment.
What does 'homebound' mean for Medicare?
Homebound means leaving home requires considerable and taxing effort. You can still qualify as homebound if you occasionally leave for medical appointments, adult day care, or infrequent short trips. You do not have to be completely bedridden. Your doctor certifies your homebound status.
How long will Medicare pay for home health care?
Medicare covers home health care for as long as you continue to meet eligibility criteria — there is no set time limit. However, your condition must require skilled care and show improvement, or the care must maintain or prevent decline in a condition. Purely custodial care (help with daily activities without skilled need) is not covered.
Is there a copay for Medicare home health care?
No — Medicare covers 100% of approved home health services with no copay or deductible when you qualify. However, you pay 20% for durable medical equipment used at home. If you have a Medigap plan, the equipment copay is also covered.
Yes — Medicare covers home health care at 100% with no copay, but only when you meet specific eligibility requirements. Understanding these requirements is critical — many seniors who could qualify never access this benefit because no one told them they were eligible. Here is everything you need to know.
The 4 Eligibility Requirements
To qualify for Medicare home health care, all four of these criteria must be met simultaneously:
1. You must be homebound
Homebound means leaving your home requires considerable and taxing effort due to illness or injury. You do not have to be completely bedridden. You can still qualify if you occasionally leave for medical appointments, adult day care, or brief infrequent trips. Your doctor certifies your homebound status — if you believe you qualify, ask your doctor explicitly.
2. Your doctor must certify a need for skilled care
You must need at least one of these skilled services: skilled nursing care, physical therapy, speech-language pathology therapy, or occupational therapy. "Skilled" means care that requires the training and expertise of a licensed professional — not just help with daily activities.
3. Your care must be part-time or intermittent
Medicare covers home health for part-time or intermittent care — generally up to 8 hours per day and 28 hours per week. It does not cover round-the-clock home care or permanent home nursing.
4. You must use a Medicare-certified home health agency
The agency providing your care must be certified by Medicare. Ask any potential home health agency if they are Medicare-certified before services begin. Your doctor can also refer you to certified agencies in your area, or use the Medicare.gov Care Compare tool to find agencies near you.
What Home Health Services Medicare Covers
Skilled Nursing Care
A registered nurse or licensed practical nurse visits your home to provide wound care, injections, IV therapy, monitoring of serious illness, and education about managing your condition. This is the most common reason seniors qualify for home health.
Physical, Occupational, and Speech Therapy
Physical therapy helps restore movement and strength after illness, surgery, or injury. Occupational therapy helps you regain the ability to perform daily activities. Speech therapy addresses swallowing problems and communication difficulties — common after strokes.
Home Health Aide Services
Home health aides provide personal care (bathing, dressing, grooming) but only when you are also receiving skilled nursing or therapy services. Aide services alone do not qualify — there must be a concurrent skilled need.
Medical Social Services
A social worker helps you and your family understand your condition, plan for care needs, and connect with community resources. Covered when your doctor certifies you need it.
What Home Health Medicare Does NOT Cover
- 24-hour-a-day home care
- Homemaker services (cooking, cleaning, laundry) not related to medical care
- Personal care if that is the only care you need (help with bathing or dressing without a skilled care need)
- Meal delivery programs
- Prescription drugs administered at home (covered under Part D)
How to Access Medicare Home Health Care
- Talk to your doctor. Tell them you are having difficulty leaving home and ask if you qualify for home health care. Your doctor must conduct a face-to-face visit to certify your eligibility.
- Get a referral to a Medicare-certified agency. Your doctor, hospital discharge planner, or Medicare.gov's Care Compare tool can identify certified agencies in your area.
- The agency creates a plan of care. Working with your doctor, the agency creates a specific care plan outlining what services you will receive and how often.
- Services begin. You pay nothing for covered home health services — Medicare pays 100%.
If you are being discharged from a hospital or skilled nursing facility and need home health care, your care team must provide you with a list of Medicare-certified home health agencies in your area. You have the right to choose which agency you use — do not let anyone pressure you to use a specific one.
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