Medicare Part A covers home health care when you meet specific medical conditions, but only for skilled care — not for help with daily tasks like bathing or cooking.
Part A pays for visits from nurses, physical therapists, occupational therapists, speech therapists, and home health aides, but only if a doctor orders the care and you cannot leave home without considerable difficulty. The care must be for a medical condition, not for general information. Part A covers the full cost of these visits with no copay, as long as you meet the requirements.
Home health coverage under Part A is temporary. It ends when you no longer need skilled care, when you can safely manage on your own, or when your doctor decides the care is no longer medically necessary. If you need ongoing help at home after Part A coverage stops, you may need to pay out of pocket or look into other programs.
Key Takeaways
- Part A covers skilled nursing visits, therapy, and home health aide services ordered by your doctor for a medical condition.
- You must be homebound or unable to leave home without considerable difficulty, and a doctor must order the care in writing.
- Part A pays 100 percent of the cost with no copay, but coverage is temporary and ends when you no longer need skilled care.
- Part A does not cover help with bathing, dressing, meals, or housekeeping unless it is part of a skilled service like wound care.
- If you need ongoing help after Part A coverage ends, Medicaid, private pay, or community programs may be options depending on your state and income.
What Part A Actually Covers at Home
Part A pays for skilled nursing care — wound dressing changes, medication management, catheter care, and monitoring of conditions like heart failure or diabetes. It also covers physical therapy to help you regain strength after surgery or illness, occupational therapy to help you manage daily tasks safely, and speech therapy if you have swallowing or speech problems.
Part A also covers home health aide services, but only when they are tied to skilled care. For example, if a nurse is treating a wound, the aide can help you bathe and dress on the days the nurse visits. The aide cannot come solely to help you with bathing or meals. The aide's work must support the skilled service your doctor ordered.
Medical equipment and supplies are covered under Part A when ordered by your doctor — hospital beds, wheelchairs, walkers, oxygen, and wound care supplies. You pay nothing for this equipment when it comes through a Medicare-approved home health agency.
The Requirements You Must Meet
Your doctor must order home health care in writing, and the order must state that you need skilled care for a medical condition. The doctor does not have to be your primary care doctor — it can be any doctor treating you for the condition that requires home care.
You must be homebound, which means leaving home requires considerable difficulty or is medically inadvisable. You do not have to be bedridden. You can be homebound if you can leave only with help, or if leaving causes pain or makes your condition worse. Part A uses this definition to decide who qualifies.
The home health agency must be Medicare-approved. You can ask your doctor or hospital discharge planner for a list, or you can search for agencies on Medicare.gov. Using a non-approved agency means Part A will not pay.
How Long Part A Covers Home Health
Part A covers home health for as long as your doctor says you need skilled care and you remain homebound. There is no set time limit. Some people receive home health for a few weeks after surgery; others receive it for months if they have a chronic condition that requires ongoing skilled nursing.
Coverage stops when your doctor decides you no longer need skilled care, when you improve enough to leave home safely, or when you can manage your condition on your own. Your home health agency will tell you when your doctor has ended the order. If you disagree with the decision, you have the right to appeal through Medicare.
What Part A Does Not Cover
Part A does not cover custodial care — help with bathing, dressing, toileting, meals, and housekeeping when these are the only services you need. If you need someone to help you bathe and dress but do not need a nurse or therapist, Part A will not pay. This is true even if you are homebound.
Part A does not cover 24-hour care at home. Home health visits are scheduled — typically a few times per week — not round-the-clock. If you need someone present all day and night, you would need to pay privately or look into assisted living or nursing home care.
Part A does not cover homemaker services like cleaning, laundry, or grocery shopping unless they are part of a skilled service. For example, a nurse can teach you how to prepare meals safely after a stroke, but Part A does not pay someone to cook for you.
What Happens When Part A Coverage Ends
When your doctor ends the home health order, Part A stops paying. If you still need help at home, you have several options. Medicaid may cover home care if you meet income and asset limits — these vary by state. Some states offer programs specifically for people who need help at home but do not may have access to for nursing home care.
You can also pay privately for home care through a home care agency or hire someone directly. Costs vary widely depending on the type of care and where you live. Some people use a combination of approaches — for example, paying for a home health aide a few days a week while family members help on other days.
Community programs, senior centers, and Area Agencies on Aging sometimes offer low-cost or free help with tasks like meal delivery, transportation, or light housekeeping. You can find your local Area Agency on Aging by calling 1-800-677-1116 or visiting eldercare.acl.gov.
How to Start Home Health Care Under Part A
If you are in a hospital or skilled nursing facility, the discharge planner will talk to your doctor about whether home health is needed. If your doctor agrees, the planner will arrange for a Medicare-approved agency to contact you before you leave.
If you are at home and your doctor thinks you need home health, ask your doctor to write an order. Your doctor can contact a home health agency directly, or you can find one on Medicare.gov and ask your doctor to send the order there. The agency will call you to schedule the first visit, usually within a few days.
When the home health agency calls, they will ask about your medical history and what help you need. They will also confirm your Medicare information. The first visit is usually an assessment visit where the nurse or therapist evaluates your condition and creates a care plan.
Frequently Asked Questions
Does Part A cover home health if I live alone?
Yes, living alone does not disqualify you. Part A covers home health based on medical need and whether you are homebound, not on whether someone lives with you. However, you must be able to safely receive care — for example, you must be able to answer the door or let the aide in.
What if my doctor says I need help but I am not homebound?
Part A will not cover home health if you can leave home without considerable difficulty, even if you need medical care. You may be able to receive care at a doctor's office, urgent care clinic, or outpatient therapy center instead. Ask your doctor about these options.
Can Part A cover home health after I leave the hospital?
Yes. If your doctor orders home health within a short time after hospital discharge and you meet the homebound requirement, Part A will cover it. There is no rule that you must have been in the hospital first, but many home health orders do follow a hospital stay.
Do I pay anything out of pocket for Part A home health?
No. Part A covers 100 percent of the cost of home health visits and equipment when ordered by your doctor through a Medicare-approved agency. You pay nothing — no copay, no coinsurance, no deductible.
What if the home health agency says Part A will not cover my care?
Ask the agency why in writing. You have the right to appeal if you disagree. Contact Medicare at 1-800-MEDICARE to file an appeal, or ask the home health agency for information about the appeal process.