Does insurance cover home health care?
It depends
Medicare and most health plans cover skilled, part-time home health care ordered by a doctor — but not long-term help with daily living like bathing or cooking.
- Covered when A doctor certifies you're homebound and need intermittent skilled care from a Medicare-certified agency — Medicare covers the skilled services.
- Covered when You need long-term daily help: Medicaid may cover it if you qualify financially, or a long-term-care insurance policy if you have one.
- Not when The only care needed is custodial — help with bathing, dressing, meals, or housekeeping — with no skilled-care need.
What flips the answer
- Covered when
A doctor certifies you're homebound and need intermittent skilled care from a Medicare-certified agency — Medicare covers the skilled services.
- Covered when
You need long-term daily help: Medicaid may cover it if you qualify financially, or a long-term-care insurance policy if you have one.
- Not covered when
The only care needed is custodial — help with bathing, dressing, meals, or housekeeping — with no skilled-care need.
Key facts
- Verdict
- It depends
- Applies to
- home health care · Health insurance
- Covered when
- A doctor certifies you're homebound and need intermittent skilled care from a Medicare-certified agency — Medicare covers the skilled services.
- Not covered when
- The only care needed is custodial — help with bathing, dressing, meals, or housekeeping — with no skilled-care need.
- Verified
- 2026-07-03 · 1 primary source
Under Medicare, home health care is covered when a doctor certifies you are homebound and need intermittent skilled care — skilled nursing, physical therapy, occupational therapy, or speech therapy — and the care comes from a Medicare-certified home health agency. When those conditions are met, Medicare pays the full cost of the covered skilled services; for any durable medical equipment, you pay 20% of the Medicare-approved amount.
What's not covered is ongoing custodial care — help with bathing, dressing, eating, or housekeeping — when that's the only care you need. Around-the-clock care, home-delivered meals, and homemaker services fall outside the benefit.
Private and employer health plans follow a similar logic: they cover medically necessary skilled home health, not long-term personal or custodial care. That long-term help is what long-term-care insurance or, for those who qualify financially, Medicaid is designed to pay for.
What people typically pay
With Medicare and the requirements met, you pay nothing for covered home health services — skilled nursing, therapy, and part-time aide help. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for Medicare-covered durable medical equipment. Private and employer plans generally apply your normal deductible and coinsurance to skilled home health, though terms vary by plan.
Paying out of pocket, costs for skilled nursing visits, home health aide hours, and full-time custodial or private-duty care vary widely by region and agency and can add up quickly. Ask specific agencies for their rates.
Custodial-only care generally isn't reimbursed by Medicare or health plans — that's where long-term-care insurance or, for those who qualify financially, Medicaid comes in. Medicaid eligibility depends on income and assets and varies by state.
How to actually get it covered
Ask your provider whether you qualify as homebound and need part-time or intermittent skilled care — nursing, physical, occupational, or speech therapy — and get a face-to-face assessment documented.
Have the provider order your care and establish a plan of care specifying the skilled services and frequency.
Choose a Medicare-certified home health agency — non-certified agencies can't provide Medicare-covered home health. Your provider should give you a list of agencies serving your area.
Before care starts, the agency should tell you how much Medicare will pay and give you an Advance Beneficiary Notice (ABN) for any items or services Medicare won't cover, so you know what you'd owe.
Confirm how billing works with the agency, and note the 20% coinsurance (after the Part B deductible) if durable medical equipment is part of the plan.
Have your provider continue to order and recertify the plan of care to keep coverage continuous, and ask about your appeal rights if the agency issues a notice that Medicare will stop paying.
Common questions
How does the 'homebound' requirement actually get decided for Medicare?
A doctor must certify that leaving home isn't recommended because of your condition, or that you have trouble leaving without help — like a cane, wheelchair, walker, crutches, special transportation, or another person — and that leaving takes a lot of effort. You can still qualify if you leave for medical treatment or short, infrequent non-medical trips like religious services. A face-to-face assessment by a health care provider is required before they can certify that you need home health services.
What does 'intermittent' skilled care mean, and can I get daily visits?
In most cases, 'part-time or intermittent' means skilled nursing and home health aide care combined up to 8 hours a day, for a maximum of 28 hours a week — with more frequent care possible for a short time (still under 8 hours a day and up to 35 hours a week) if your provider decides it's necessary. Care needed more than part-time or intermittent doesn't fit the benefit. If you qualify, you can get unlimited home health visits as long as your provider keeps ordering the care.
If I get skilled nursing visits, will a home health aide's help with bathing be covered too?
Yes — Medicare covers part-time or intermittent home health aide services like help with bathing, grooming, walking, and feeding, but only if you're also getting skilled nursing care or therapy at the same time. Once the qualifying skilled care ends, that personal-care help is no longer covered on its own, since custodial care is not covered when it's the only care you need.
Does auto insurance ever pay for home health care after a crash?
It can depend on your state and policy. If you're injured in a car accident, some auto coverages like Personal Injury Protection (PIP) or medical payments (MedPay) may pay for medically necessary care related to those injuries, subject to your policy limits. This is separate from Medicare or your health plan. Check your declarations page for any PIP or MedPay limits before assuming it's covered.
How long will coverage last before it stops?
Medicare covers home health as long as you keep meeting the requirements — homebound status plus a documented skilled need — and your provider keeps ordering and recertifying the plan of care. If you qualify, you can get unlimited home health visits. Coverage ends when you no longer need skilled care or are no longer homebound, not after a set number of visits.
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