Be under a provider’s care
A doctor or other allowed provider oversees your home health plan.
Medicare & Home Health Care
Does Medicare Cover Home Health Care?
Yes—Medicare can cover certain skilled home health services when you meet its eligibility requirements. It does not cover every kind of help a person may need at home.
The Short Answer
Medicare may pay for skilled, intermittent care at home—not ongoing custodial care.
- Homebound under Medicare’s definition
- Needs qualifying skilled care
- Provider-ordered plan of care
- Medicare-certified agency
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The Short Answer
Medicare covers skilled care at home in specific circumstances.
Medicare Part A and/or Part B may cover medically necessary home health care when you are homebound, need part-time or intermittent skilled services, are under a provider’s care, and receive services under an approved plan from a Medicare-certified home health agency.
Your provider and home health agency document whether the requirements are met. Review Medicare’s current coverage rules.
Skilled care is the dividing line.
Medicare’s home health benefit is designed for skilled care related to an illness or injury. It is not a general benefit for ongoing household help, meals, or round-the-clock personal care.
Eligibility Checklist
Six requirements Medicare generally expects you to meet.
Coverage is case-specific. Your provider and agency must document the requirements rather than relying on a general description alone.
Be considered homebound
Your condition makes leaving medically inadvisable or requires equipment, special transportation, or another person’s help—and leaving takes considerable effort.
Need a qualifying skilled service
This may be intermittent skilled nursing, physical therapy, speech-language pathology, or qualifying occupational therapy.
Follow a written care plan
Your provider establishes and regularly reviews a plan describing the services you need.
Complete a face-to-face assessment
The encounter must relate to the reason you need home health care and occur within Medicare’s required timeframe.
Use a Medicare-certified agency
The home health agency providing your covered care must participate in Medicare.
Homebound does not mean you can never leave home. Brief or infrequent trips for medical care, religious services, adult day care, or a special event do not automatically disqualify you. Read CMS’s detailed homebound criteria.
Covered Services
What Medicare-covered home health care can include.
Each service must be reasonable and necessary for treating an illness or injury and included in the approved care plan.
Skilled nursing care
Medically necessary, intermittent services such as wound care, injections, IV or nutrition therapy, education, and monitoring of serious or unstable conditions.
Therapy services
Physical therapy, speech-language pathology, and occupational therapy when Medicare’s clinical requirements are met.
Home health aide care
Part-time or intermittent personal care only while you are also receiving qualifying skilled care through the home health agency.
Medical social services
Counseling or help locating community resources when included in the skilled home health plan.
Certain supplies and equipment
Some supplies ordered as part of the care plan may be covered. Durable medical equipment follows separate Part B cost-sharing rules.
Review Medicare’s beneficiary guide for the current covered-service list.
What Medicare generally does not cover
- 24-hour-a-day care in your home
- Meals delivered to your home
- Shopping, cleaning, laundry, or other homemaker services unrelated to the medical care plan
- Custodial or personal care when that is the only care you need
- Long-term supervision instead of qualifying intermittent skilled care
Medicare can cover aide care as part of a skilled home health episode, but it does not generally pay for personal-care help by itself.
Costs & Visit Limits
What could you pay?
Before care starts, the agency should explain what Medicare is expected to pay and warn you before providing services it expects Medicare not to cover.
$0
For Medicare-approved home health services when you qualify.
20%
Of the Medicare-approved amount for covered durable medical equipment after the Part B deductible.
If the agency expects Medicare not to cover an item or service, it should provide an Advance Beneficiary Notice of Noncoverage. Accepting the service may make you responsible for the cost.
There is no simple annual visit cap, but care must remain part-time or intermittent. In most cases, combined nursing and aide services may be up to 8 hours a day and 28 hours a week, with up to 35 hours for a short medically necessary period.
Getting Care
How to start Medicare-covered home health care.
The process begins with your treating provider—not with a general request for household help.
- 1
Talk with your provider
Ask whether your medical needs and ability to leave home may meet Medicare’s requirements.
- 2
Complete the assessment
Your provider documents the need for care through a qualifying face-to-face encounter.
- 3
Get the order and care plan
The provider orders the services and establishes the plan of care.
- 4
Choose a certified agency
Use Medicare Care Compare to review agencies that serve your area.
- 5
Confirm coverage
Ask what Medicare is expected to cover, whether an Advance Beneficiary Notice applies, and what you could owe.
Medicare Advantage
Check your plan before scheduling care.
Medicare Advantage plans provide Medicare-covered benefits, but they may use provider networks, prior authorization, referral rules, and different cost-sharing. Contact your plan and confirm which home health agencies are in network.
Your Evidence of Coverage and plan representatives control plan-specific details. Do not assume every Original Medicare administrative step works the same way under your plan.
Planning for the Gaps
What if Medicare does not cover enough help?
A person can need meaningful help at home without meeting Medicare’s skilled-care rules—or still need meals, household help, extended personal care, and broader financial support after a covered episode.
- What skilled services will Medicare cover now?
- What daily support will still be needed?
- Which costs may require other resources or supplemental coverage?
Frequently Asked Questions
Direct answers about Medicare and care at home.
Does Medicare cover a home health aide?
Medicare may cover part-time or intermittent home health aide services when you are also receiving qualifying skilled nursing or therapy through the home health agency. It generally does not cover an aide when personal care is the only service you need.
Does Medicare cover 24-hour home care?
No. Medicare does not cover round-the-clock care at home under the home health benefit.
Can I leave home and still be considered homebound?
Yes. Brief or infrequent absences—including medical appointments, religious services, adult day care, or special events—do not automatically prevent eligibility. Your condition must still make leaving home difficult, medically inadvisable, or a considerable effort.
Does Medicare cover physical therapy at home?
It can. Physical therapy may be covered when it is medically necessary, ordered under the home health plan, and the other eligibility requirements are met.
Does Medicare cover help with bathing and dressing?
Only in limited circumstances. Part-time or intermittent aide care may be covered while you are also receiving qualifying skilled care. Custodial or personal care by itself is generally not covered.
How do I find a Medicare-certified home health agency?
Ask your provider for agencies serving your area and use Medicare Care Compare to confirm certification and review quality information.
Keep Exploring
Understand where Medicare ends—and what other options may help.
Vistara’s home health coverage page explains supplemental products that may help families plan for some costs Medicare does not cover. Benefits, eligibility, limitations, and availability vary by product and state.
Vistara Resource Standard
Vistara resources explain insurance concepts in plain language and point readers to relevant primary sources. Benefits, availability, underwriting, premiums, exclusions, limitations, and policy terms vary by product and state. Only the issued policy and carrier materials control.