Does Medicare cover home health care?

What home health services does Medicare cover?

Medicare covers health care services you get in your home for an illness or injury, to help you get better, maintain your current condition or level of function, or slow your rate of decline. Medicare-covered home health services include:

• Medically necessary part-time or intermittent skilled nursing care, like wound care for pressure sores or a surgical wound, patient and caregiver education, intravenous or nutrition therapy, injections, and monitoring a serious illness or unstable health status.
• Physical therapy, occupational therapy and speech-language pathology services, if you meet certain conditions.
• Medical social services.
• Part-time or intermittent home health aide care, like help with walking, bathing or grooming, changing bed linens and feeding, only if you're also getting skilled nursing care, physical therapy, speech-language pathology services or occupational therapy at the same time.
• Injectable osteoporosis drugs for women who meet certain criteria.
• Durable medical equipment and medical supplies for use at home (see how Medicare covers durable medical equipment).

Who qualifies for Medicare home health care?

To qualify, you must need part-time or intermittent skilled services and be homebound. You won't qualify if you need more than part-time or intermittent skilled care. You can still leave home for medical treatment or for short, infrequent absences for non-medical reasons, like attending religious services, and you can still get home health care if you attend adult day care.

Being homebound means you meet both of these conditions:

• Leaving your home isn't recommended because of your condition, or you have trouble leaving your home without help (like using a cane, wheelchair, walker or crutches, special transportation, or help from another person) because of an illness or injury.
• You're normally unable to leave your home, and leaving takes a lot of effort.

How do I start getting home health care through Medicare?

A doctor or other health care provider, like a nurse practitioner, must see you in person, confirm that you need home health care and order it, and a Medicare-certified home health agency must provide it. Your provider should give you a list of agencies that serve your area and must tell you if their organization has a financial interest in any agency on the list.

Your home health agency works with you and your provider to create a care plan that lists the services you need, who should give them, how often you need them, the medical equipment you need and the results your provider expects. Your provider and home health team should review the plan as often as necessary, but at least once every 60 days. If you need occupational therapy, your provider must first order it along with nursing care, physical therapy or speech-language pathology; after that, you can keep getting occupational therapy on its own.

If you get services from a home health agency in Florida, Illinois, Ohio, North Carolina or Texas, a Medicare demonstration program lets the agency ask Medicare for a pre-claim review of coverage. Your Medicare home health benefits haven't changed, and the pre-claim review shouldn't delay your access to home health services.

What do I pay for Medicare home health care?

You pay nothing for covered home health services. After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for Medicare-covered medical equipment.

Before your care starts, the home health agency should tell you how much Medicare will pay, and tell you, both verbally and in writing, about any items or services Medicare won't pay for and how much you'd owe. The agency should give you an Advance Beneficiary Notice (ABN) before giving you services and supplies that Medicare doesn't cover.

If you get Medicare through a Medicare Advantage Plan or another Medicare health plan, check with your plan about its home health benefits; Medicare Advantage plans include Part A and Part B coverage, and rules and costs vary by plan. If you have a Medicare Supplement Insurance (Medigap) policy or other health insurance, tell your doctor or other provider so your bills get paid correctly.

How many hours of home health care does Medicare cover?

If you qualify, Medicare covers unlimited home health visits, and home health staff should visit you as often as your provider orders. In most cases, “part-time or intermittent” means you may be able to get skilled nursing care and home health aide services up to 8 hours a day (combined), for a maximum of 28 hours a week. You may be able to get more frequent care for a short time (less than 8 hours a day and up to 35 hours a week) if your provider decides it's necessary.

What doesn't Medicare cover at home?

Medicare doesn't pay for these home services:

• 24-hour-a-day care at your home.
• Home meal delivery.
• Homemaker services, like shopping and cleaning, unrelated to your care plan.
• Custodial or personal care that helps with daily living activities, like bathing, dressing or using the bathroom, when this is the only care you need. Medicare and Medigap don't pay for long-term care; see Medicare and long-term care.