The Home Health Guide
What Medicare Covers for Home Health Care
Original Medicare pays 100% of covered home health services. See what is covered, what you pay for equipment and what Medicare will not pay for.
If you qualify, Original Medicare pays 100% of covered home health services, with no deductible, no copay and no limit on the number of visits. The main cost you may see is 20% of the Medicare-approved amount for medical equipment, such as a walker or hospital bed, after your Part B deductible. Medicare does not pay for round-the-clock care, housekeeping or personal care when that is the only help you need.
What Medicare covers at home
| Service | Covered? | What you pay |
|---|---|---|
| Part-time skilled nursing | Yes | $0 |
| Physical, occupational and speech therapy | Yes | $0 |
| Medical social services | Yes | $0 |
| Home health aide (bathing, personal care) | Only alongside skilled care | $0 |
| Medical supplies used in your care, such as wound dressings | Yes | $0 |
| Durable medical equipment, such as a walker or wheelchair | Yes | 20% after the Part B deductible |
| Injectable osteoporosis drugs for women who meet certain conditions | Yes | Varies |
What Medicare does not cover
- 24-hour care at home
- Meals delivered to your home
- Homemaker services, such as cleaning, laundry and shopping, that are not part of your care plan
- Personal care, such as bathing, dressing or using the bathroom, when it is the only care you need
This everyday help is often called home care. Families usually pay for it privately, through long-term care insurance or, for people who qualify, through Medicaid. See home health vs. home care for typical costs.
Part A or Part B?
Both parts of Medicare can pay for home health care. Part A generally pays after a qualifying stay in a hospital or skilled nursing facility, and Part B pays in other cases. Either way, you pay nothing for covered home health services, so you rarely need to know which part is paying.
How long Medicare pays
There is no set limit. Your practitioner certifies your plan of care for 60 days at a time, and Medicare keeps paying as long as you remain homebound, still need skilled care and your plan is recertified.
If the agency says something is not covered
Before giving you an item or service Medicare may not pay for, the agency should explain it and give you an Advance Beneficiary Notice. That notice tells you what may not be covered and how much it could cost, so you can decide whether you want it. If covered services are ending, you get a written notice that explains how to request a fast appeal.
Medicare Advantage, Medigap and Medicaid
- Medicare Advantage: plans cover home health care, but costs, approval rules and agency networks vary. Check with your plan before you choose an agency.
- Medigap: a Medigap policy can help with the 20% equipment coinsurance. Tell your agency about any extra coverage so bills go to the right place.
- Medicaid: may cover home health care and, in many states, some home care services that Medicare does not.
Common questions
Will I get a bill for home health visits?
With Original Medicare, covered home health visits cost you nothing. You might be billed for medical equipment or for services you agreed to in writing that Medicare does not cover.
Does Medicare pay for a caregiver at home?
Medicare pays for a home health aide only for part-time help while you are also getting skilled nursing or therapy. It does not pay for a caregiver who provides only personal care or supervision.
Is there a limit on visits?
No. If you qualify, Medicare covers as many visits as your plan of care calls for, within the part-time limits.
Sources
This guide is general information, not medical or legal advice. See our medical disclaimer.