Medicare does cover home healthcare, but only under specific conditions
Medicare Part A and Part B together pay for home healthcare services when a doctor orders them and you meet certain requirements. You must be homebound (unable to leave home without considerable effort), have a medical need for skilled care, and receive services from a Medicare-certified agency. Medicare does not pay for help with daily living tasks alone — only for skilled nursing, therapy, or medical equipment tied to a condition your doctor is treating.
The most common covered services are skilled nursing visits, physical therapy, occupational therapy, and speech-language pathology. Medicare also covers medical equipment like oxygen, wheelchairs, and hospital beds if your doctor prescribes them. What Medicare does not cover is custodial care — bathing, dressing, meal preparation, or housekeeping — unless those tasks are part of a skilled service your nurse or therapist is performing.
Key Takeaways
- Medicare covers home healthcare only when a doctor orders it, you are homebound, and a Medicare-certified agency provides the care.
- Skilled nursing visits, physical therapy, occupational therapy, and speech-language pathology are the main covered services.
- Medicare does not pay for custodial care like bathing or housekeeping unless a skilled nurse or therapist is performing those tasks as part of treatment.
- You typically pay nothing out of pocket for home healthcare services covered by Medicare Part A or Part B, but the agency must be certified and your doctor must order the care.
- Home healthcare coverage is temporary and tied to your medical condition — once you no longer need skilled care, coverage ends.
What counts as homebound under Medicare rules
To receive Medicare-covered home healthcare, you must be unable to leave your home without considerable and taxing effort. This does not mean you never leave — you can attend medical appointments or go to religious services occasionally. What matters is that leaving home requires help from another person, special transportation, or causes you significant pain or exhaustion.
A doctor must document that you are homebound before any home healthcare visits are covered. The certification is based on your actual medical condition, not on whether you choose to stay home. If you are able to leave independently — even if you prefer not to — Medicare will not cover home healthcare services.
How to start the process with your doctor
Your doctor must order home healthcare and specify what type of care you need. You cannot request it on your own or have a family member request it. When you see your doctor, explain that you are having difficulty managing at home due to your medical condition and ask whether home healthcare might help.
If your doctor agrees, they will write an order and send it to a Medicare-certified home health agency. You can ask your doctor which agencies they work with, or you can search for certified agencies in your area through Medicare.gov. Once an agency receives your doctor's order, a nurse will visit to assess your needs and create a care plan.
The entire process — from your doctor's order to your first visit — usually takes a few days to a week. There is no waiting list, but the timing depends on how quickly your doctor submits the order and how quickly the agency can schedule an initial visit.
What Medicare Part A and Part B each cover
Medicare Part A covers home healthcare services when you are discharged from a hospital or skilled nursing facility and need continued care at home. Part A typically covers the full cost of skilled nursing visits, therapy, and medical equipment with no copay or deductible, as long as the agency is certified.
Medicare Part B covers home healthcare services for people who have not recently been in the hospital. Part B requires you to meet your annual deductible before coverage begins, and then you typically pay 20 percent of the cost of each service. However, many people with Part B also have supplemental insurance (Medigap) or a Medicare Advantage plan that covers some or all of the remaining cost.
The type of Medicare coverage you have does not change what services are covered — only how much you pay. Both Part A and Part B cover the same skilled services when ordered by a doctor.
Services Medicare will and will not pay for at home
| Service | Medicare Covers | Medicare Does Not Cover |
|---|---|---|
| Skilled nursing care | Yes — wound care, medication management, catheter care, injections | No — routine check-ins with no skilled task |
| Physical therapy | Yes — ordered by doctor to restore function after injury or illness | No — exercise programs for general fitness |
| Occupational therapy | Yes — retraining for daily activities after stroke or injury | No — general wellness or life coaching |
| Speech-language pathology | Yes — swallowing therapy or speech recovery after stroke | No — voice coaching or accent reduction |
| Medical equipment | Yes — oxygen, wheelchairs, hospital beds, walkers (prescribed by doctor) | No — comfort items or convenience equipment |
| Bathing and dressing | Only if part of a skilled nursing or therapy visit | No — custodial care alone |
| Meal preparation | No — even if you cannot do it yourself | Custodial care, not skilled care |
| Housekeeping | No — even if ordered by doctor | Custodial care, not skilled care |
How long Medicare home healthcare coverage lasts
Medicare covers home healthcare for as long as your doctor says you need it and you remain homebound. There is no set time limit — some people receive services for a few weeks after surgery, while others receive them for months during recovery from a stroke or serious illness.
Your home health agency will reassess your progress regularly. If you improve enough to no longer need skilled care, or if you become able to leave home without considerable effort, coverage will end. Your doctor and the agency will notify you before this happens, usually with at least a few days' notice.
If your condition changes and you need home healthcare again later, your doctor can order it again. There is no limit to how many times you can receive home healthcare services during your lifetime, as long as each episode is medically necessary and ordered by a doctor.
Finding a Medicare-certified home health agency
Not all home health agencies are certified by Medicare. You need a certified agency for Medicare to pay. You can search for certified agencies in your area on Medicare.gov by using the "Care Compare" tool, or you can ask your doctor which agencies they recommend.
When you contact an agency, ask whether they are Medicare-certified and whether they accept your specific Medicare plan (Original Medicare, Medicare Advantage, or both). Some agencies work only with certain plans. The agency should also be able to tell you what services they offer and whether they have availability in your area.
You have the right to choose which certified agency provides your care. If you are not satisfied with the first agency, you can ask your doctor to send the order to a different one. Changing agencies is free and does not affect your coverage.
Frequently Asked Questions
Do I have to pay anything for home healthcare covered by Medicare?
If you have Medicare Part A, you typically pay nothing for covered home healthcare services. If you have Medicare Part B only, you pay 20 percent of the cost after you meet your annual deductible. Many people with Part B have supplemental insurance that covers some or all of this cost.
What if my doctor says I need help with bathing but I am not getting skilled nursing care?
Medicare does not cover bathing or dressing as standalone services. If you need help with these tasks, you would need to pay out of pocket or look into Medicaid programs in your state, which may cover custodial care. Some home health agencies offer private-pay services for tasks Medicare does not cover.
Can I receive home healthcare if I live in an assisted living facility or nursing home?
Medicare home healthcare is intended for people living in their own homes. If you live in a facility, the facility is responsible for providing care, and Medicare covers services through the facility's staff instead. Ask the facility's social worker what services are available to you.
How do I know if an agency is really Medicare-certified?
You can check on Medicare.gov using the Care Compare tool, or you can call Medicare at 1-800-MEDICARE and ask. You can also ask the agency directly for their Medicare certification number. Certified agencies display their certification status and are regularly inspected by Medicare.
What happens if I improve and no longer need home healthcare?
Your doctor and the home health agency will monitor your progress. When you no longer need skilled care or are no longer homebound, the agency will discharge you. You will be notified before this happens, and coverage will end on the date your doctor specifies.