Updated October 15, 2026
Does Medicare cover home health care? Yes. Medicare Part A and Part B cover part-time or intermittent skilled home health care at $0 if you’re homebound, a doctor or other approved provider certifies that you need it, and you use a Medicare-certified home health agency. Medicare doesn’t cover 24-hour care or help with daily tasks when that’s the only care you need.
Many people assume Medicare will pay for any care provided at home, but that’s not always true. The home health benefit is designed to help you recover from illness, injury, or surgery at home, and it only covers specific, medically necessary services.
Understanding what’s covered (and what isn’t) can help you avoid surprise bills. Whether you’re managing a chronic condition, helping a loved one recover from surgery, or trying to stay independent, knowing the rules can make all the difference.
Key Takeaways
- Medicare covers part-time skilled home health services, not 24-hour or custodial care.
- To qualify, you must be homebound, have care ordered by a doctor or other approved provider after an in-person visit, and use a Medicare-certified agency.
- Covered home health services cost $0. Medical equipment costs 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026).
- There’s no limit on the number of visits as long as you keep qualifying.
- Your agency must notify you in writing before it reduces or stops your services, and you can ask for a fast appeal.
Medicare and Home Health Care: The Basics
Medicare defines home health care as part-time or intermittent skilled care delivered under a plan of care. This might include nursing visits, physical therapy, or help from a home health aide, but only when those services are medically necessary and part of an approved plan.
Home health care is covered under Medicare Part A (hospital insurance) or Part B (medical insurance), depending on your situation. If you’ve recently been hospitalized, your care might fall under Part A. If you’re receiving ongoing treatment for a chronic condition, it may be billed under Part B. Learn more about how the parts fit together in our guide to Medicare and Medicaid.
Medicare doesn’t cover 24-hour in-home care or personal help that isn’t tied to a medical need. Those services count as custodial or long-term care, which Medicare does not pay for.
Who Qualifies for Medicare Home Health Care?
You qualify for Medicare-covered home health care when you meet all four of these requirements.
1. A provider’s order and plan of care
A doctor or other approved provider, such as a nurse practitioner, must see you in person, certify that you need skilled care like nursing or therapy, and order a written plan of care. The plan is reviewed and renewed at least every 60 days.
2. Homebound status
Medicare requires that you be “homebound.” That means leaving home is very difficult without help, such as a cane, wheelchair, or another person, and takes considerable effort. You can still leave for medical care, adult day care, or brief, infrequent outings.
3. A Medicare-certified home health agency
You must receive care from a Medicare-certified agency. You can compare certified agencies near you with Medicare’s Care Compare tool.
4. Skilled, not custodial, care
Medicare only covers skilled services like wound care, injections, or therapy. It doesn’t cover help with bathing, meals, or housekeeping unless that help is part of a skilled care plan.
Tip: Ask your provider, “Does my care plan meet Medicare’s skilled care criteria?” before services start.
What Medicare Covers for Home Health Care
When you meet the eligibility requirements, Medicare covers:
- Skilled nursing care, such as wound care, injections, IV therapy, and monitoring an unstable condition
- Physical, occupational, and speech-language therapy
- Medical social services to help coordinate care and connect you with community resources
- Home health aide services, such as help bathing, dressing, or walking, but only while you’re also getting skilled nursing or therapy
- Durable medical equipment (DME), such as walkers, hospital beds, or oxygen equipment, and medical supplies for use at home
- Injectable osteoporosis drugs for women who meet certain criteria
Care must be part-time or intermittent. That usually means up to 8 hours a day and 28 hours a week of nursing and aide care combined. Your provider can approve up to 35 hours a week for a short time if needed. There’s no limit on the number of visits as long as you continue to qualify.
Example: If you’re recovering from hip surgery, Medicare might cover a visiting nurse to monitor your healing and a physical therapist to help restore mobility. It wouldn’t cover a full-time aide for daily help.
What Medicare Doesn’t Cover
Medicare draws a clear line between skilled medical care and personal help at home. This is where many families get tripped up. Medicare does not cover:
- 24-hour in-home care
- Custodial care, such as help with dressing, bathing, or meals, when that’s the only care you need
- Meal delivery
- Homemaker services like cooking or cleaning that aren’t part of your care plan
- Services from agencies that aren’t Medicare-certified
If you hire someone privately to help with daily living, Medicare won’t reimburse that cost.
Tip: Even a service that seems medical, like checking blood pressure, isn’t covered unless it’s part of a certified, skilled plan of care.
How Much Does Medicare Home Health Care Cost?
For most people, covered home health services cost nothing, as long as all eligibility requirements are met.
- Covered home health services: $0
- Durable medical equipment: 20% of the Medicare-approved amount after you meet the Part B deductible, which is $283 in 2026
- Medicare Advantage (Part C): Plans must cover the same services, but costs and rules vary. Many require prior authorization, and some offer extras like caregiver support. Medigap policies may help with the 20% for equipment.
Before care starts, the agency should tell you, in writing, what Medicare will and won’t pay. If it plans to provide a service or supply Medicare doesn’t cover, it should give you an Advance Beneficiary Notice (ABN) first. If a service isn’t medically necessary, you may be responsible for the full bill.
How to Start Home Health Care
The process begins with your provider, who decides whether you need skilled care and refers you to a certified agency.
- Talk with your doctor about your medical needs and recovery goals.
- Get a referral to a Medicare-certified home health agency.
- The agency assesses your needs and builds a plan of care with your provider.
- Review and sign your plan of care and consent forms before services begin.
- Keep track of your progress and your recertification date, at least every 60 days.
Tip: Keep copies of all care plans, assessments, and progress notes. They can help if there’s ever a billing or coverage dispute. Our guide to organizing a loved one’s medical information can help.
What If Your Agency Cuts or Stops Your Care?
Your agency must tell you in writing before it changes your care:
- Home Health Change of Care Notice: given when the agency plans to reduce or stop some services, such as cutting therapy visits.
- Notice of Medicare Non-Coverage: given at least two days before all of your covered services end. It explains how to request a fast appeal, which an independent reviewer decides.
For other denied claims, follow the instructions on your Medicare Summary Notice or plan notice, or see Medicare’s appeals page. Our guide to appealing a denied claim walks through how to build a strong appeal.
Special Considerations
- Medicare Advantage (Part C): Some plans include extras like transportation or meal delivery during recovery. Compare plan types in our HMO vs. PPO guide.
- Telehealth: Agencies can use virtual check-ins to support your care, but they don’t replace the in-person visits in your plan.
- Post-hospital care: Hospitals often arrange home health services before discharge.
- Dual eligibility (Medicare and Medicaid): Many states offer Medicaid home and community-based services, such as personal care or meals, that Medicare doesn’t cover.
Sample Scenarios
These examples are hypothetical, but they show how the rules work in common situations.
After surgery
John, 72, has knee replacement surgery. His doctor orders physical therapy and wound care at home. Because he’s temporarily homebound and uses a Medicare-certified agency, his home health visits cost $0. If he needs a walker, he’ll pay 20% of its approved cost after the Part B deductible.
Chronic illness
Maria, 80, has diabetes and heart failure. She gets periodic nursing visits to monitor her condition and medications. Medicare covers her part-time skilled nursing, but not the companion who helps with grocery shopping.
Personal care only
Sam’s family hires a private caregiver to help him bathe. Because Sam doesn’t need skilled nursing or therapy, Medicare won’t pay for it, and the family covers the full cost. If Sam later needs skilled care at home, an aide could help with bathing as part of that plan.
Questions to Ask Before You Start
- Am I under a home health plan of care?
- Does my condition require skilled care?
- Is my agency Medicare-certified?
- How long will my plan last, and who reviews it?
- What out-of-pocket costs should I expect?
- What equipment or supplies are billed separately?
Frequently Asked Questions
Does Medicare pay for 24-hour home care?
No. Medicare only covers part-time or intermittent skilled care, usually up to 8 hours a day and 28 hours a week. It doesn’t cover round-the-clock care.
Can I choose my own home health agency?
Yes, as long as it’s Medicare-certified. You can compare agencies with Care Compare.
How long can I receive home health care?
There’s no set limit. You can keep getting care as long as you qualify and your provider recertifies your plan, usually every 60 days.
Does Medicare cover physical therapy at home?
Yes, if it’s medically necessary and part of your approved plan of care.
Does Medicare cover a home health aide?
Yes, but only part-time and only while you’re also getting skilled nursing or therapy. Medicare won’t pay for an aide if personal care is the only help you need.
What if my claim is denied or my care is ending?
You can appeal. If your agency is ending all services, follow the fast-appeal instructions on your Notice of Medicare Non-Coverage. For other denials, follow your notice or call 1-800-MEDICARE.
Learn More with Patient.com
Navigating Medicare can feel overwhelming, but you don’t have to do it alone. If you’re helping a parent or spouse, start with our caregiver’s guide to Medicare, and explore more Patient.com guides on Medicare, home care, and patient advocacy.
