Does Medicare cover home health care?
It depends
Medicare covers home health care only when you're homebound and a doctor certifies you need part-time skilled nursing or therapy — it does not cover round-the-clock care or help with daily living alone.
- Covered when A doctor certifies you're homebound and need part-time skilled nursing care or physical, occupational, or speech therapy from a Medicare-certified home health agency.
- Not when You need full-time (24-hour) care at home, rather than part-time skilled visits.
- Not when The only help needed is custodial — bathing, dressing, meal prep, housekeeping — with no accompanying skilled nursing or therapy need.
What flips the answer
- Covered when
A doctor certifies you're homebound and need part-time skilled nursing care or physical, occupational, or speech therapy from a Medicare-certified home health agency.
- Not covered when
You need full-time (24-hour) care at home, rather than part-time skilled visits.
- Not covered when
The only help needed is custodial — bathing, dressing, meal prep, housekeeping — with no accompanying skilled nursing or therapy need.
Key facts
- Verdict
- It depends
- Applies to
- home health care · Medicare
- Covered when
- A doctor certifies you're homebound and need part-time skilled nursing care or physical, occupational, or speech therapy from a Medicare-certified home health agency.
- Not covered when
- You need full-time (24-hour) care at home, rather than part-time skilled visits.
- Verified
- 2026-07-02 · 1 primary source
Medicare covers home health care under fairly specific conditions: you must be under a doctor's care with a certified plan of care, be considered homebound, and need part-time skilled nursing care or physical, occupational, or speech therapy. When those conditions are met, a Medicare-certified home health agency can provide skilled nursing visits, therapy, and a home health aide for personal care tied to that skilled need — generally with no cost to you for the covered services.
The most common source of confusion is what Medicare does not cover: 24-hour care at home, meals delivered to the home, homemaker services like cleaning or shopping when they're the only service needed, and personal or custodial care (help with bathing, dressing, using the bathroom) when that's the only care needed and no skilled nursing or therapy is involved.
This means a family looking for ongoing help with an aging parent's daily activities, without a skilled medical need driving it, generally will not find that covered by Medicare — even though it's the scenario many people have in mind when they ask this question.
What people typically pay
When you meet the requirements, you pay nothing for the covered skilled nursing, therapy, and aide visits. The main out-of-pocket piece is 20% of the Medicare-approved amount for any Medicare-covered durable medical equipment the agency provides, after you meet the Part B deductible.
Paying privately, in-home care costs vary widely by region and agency, and hours can add up quickly, so it's worth getting quotes locally. Exact rates depend on how much care is needed and local labor rates.
Costs swing based on how many hours and what level of skill are needed, plus local labor rates and whether the care is skilled or custodial.
How to actually get it covered
Talk to your treating doctor about whether you need part-time or intermittent skilled nursing or physical, occupational, or speech therapy, and whether you meet the homebound definition.
Have a health care provider complete the required face-to-face assessment and order your care under a written plan of care documenting the skilled need.
Ask for a referral to a Medicare-certified home health agency; your provider should give you a list of agencies serving your area.
When the agency starts, confirm which services Medicare covers and get an Advance Beneficiary Notice for anything that isn't covered.
Check in with your doctor periodically to confirm you still meet the requirements so care continues without a gap.
If a service is denied, request a written explanation and follow the appeal process listed on your Medicare paperwork.
Common questions
Do I pay anything for covered home health visits?
For services that meet Medicare's home health criteria, you generally owe nothing for the skilled nursing, therapy, or aide visits themselves. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for any durable medical equipment provided, like a wheelchair or walker. Before care begins, the agency should give you an Advance Beneficiary Notice if something won't be covered so there are no surprises.
What does it mean to be 'homebound' for Medicare purposes?
Homebound doesn't mean you can never leave the house. It means you normally can't leave home, and leaving takes a lot of effort — you may need help such as a cane, walker, wheelchair, crutches, special transportation, or another person. You may still leave home for medical treatment or short, infrequent non-medical outings like religious services, and attending adult day care doesn't disqualify you.
How often does the doctor have to re-certify my home health care?
Medicare requires that a health care provider assess you face-to-face before certifying that you need home health services, and a provider must order your care under a plan of care. Your plan of care is reviewed periodically for as long as you still meet the requirements. If you no longer need skilled care or are no longer homebound, coverage ends.
If Medicare won't cover the daily-living help my parent needs, what pays for it?
Custodial-only care at home generally isn't paid by Original Medicare when there's no skilled need. Other possible sources often include Medicaid (for those who qualify financially), long-term care insurance, veterans' benefits, or out-of-pocket payment. If you have a Medicare Advantage plan, check your plan directly for any home health benefits it may offer.
Can I choose any home health agency?
The agency must be Medicare-certified for the services to be covered. If your provider decides you need home health care, they should give you a list of agencies that serve your area, and they must tell you if their organization has a financial interest in any listed agency. You're free to compare your options before choosing.
That's the general answer. Yours is written in your actual policy.
Drop in your policy or benefits document and get the answer for your exact coverage — with the clause it comes from. Nothing is stored.
Check my policy →