Medicare can pay for home health care, but specific conditions apply. Here's who qualifies and what's covered.
What home health care does Medicare cover?
Medicare Part A and Part B cover home health care when a doctor certifies you need it and you're homebound. Covered services include intermittent skilled nursing care, physical therapy, speech-language pathology, occupational therapy, medical social services, and part-time home health aide care for personal needs while you're receiving skilled care. Care must be provided by a Medicare-certified home health agency. For covered home health services you pay $0, and for any durable medical equipment supplied you pay 20% of the approved amount. Understanding the homebound and skilled-care requirements is key to qualifying. Call 1-800-MEDIGAP at 1-800-633-4427 for personalized help.
What home health care does Medicare NOT cover?
Medicare does not cover 24-hour-a-day care at home, home-delivered meals, or homemaker services like shopping and cleaning when these are the only care you need. It also does not cover custodial or personal care, help with bathing, dressing, or using the bathroom, when that's the only care required and you don't need skilled services. These long-term custodial needs typically fall to Medicaid, long-term care insurance, or out-of-pocket payment. Knowing the line between skilled and custodial care prevents surprises. To explore how to cover ongoing personal care needs, call 1-800-MEDIGAP at 1-800-633-4427 for free guidance.