Yes, Medicare Part A and Part B cover home health care, but only when specific conditions are met

Medicare will pay for skilled nursing care, physical therapy, occupational therapy, and other medical services delivered to your home — but not for general housekeeping, meal preparation, or personal care unless it is tied to a medical need. The key requirement is that a doctor must order the care, you must be homebound or have severe difficulty leaving home, and the agency must be Medicare-certified. If these conditions are in place, you typically pay nothing out of pocket for covered services.

Home health care through Medicare is different from hiring a private caregiver or housekeeper. It is medical care — wound care after surgery, medication management, physical therapy to regain strength after a fall, or monitoring for a chronic condition like heart disease. If you need help with bathing, dressing, or meals without a medical reason attached, Medicare does not cover that, though Medicaid or private pay options may.

Key Takeaways

  • A doctor must order home health care and state that you are homebound or have severe difficulty leaving home for it to be covered by Medicare.
  • Medicare Part A and Part B together cover skilled nursing, physical therapy, occupational therapy, speech therapy, and medical social work when ordered by a physician.
  • You pay nothing for Medicare-covered home health services if the agency is Medicare-certified and the care meets medical necessity requirements.
  • Home health agencies must be Medicare-certified; your doctor can refer you to one, or you can search the Medicare Care Compare tool on Medicare.gov.
  • Personal care, housekeeping, and meal preparation are not covered by Medicare unless they are part of a skilled nursing visit or therapy session.

What Medicare Part A and Part B cover at home

Medicare covers skilled nursing visits — a nurse checking your wound, changing a dressing, starting an IV, or teaching you how to manage a new medication. It covers physical therapy to help you walk again after a hip replacement or stroke, occupational therapy to help you relearn daily tasks, and speech therapy if you have swallowing or speech problems. It also covers medical social work — a social worker helping you plan for discharge or find community resources — and home health aide visits when they are ordered as part of a skilled nursing plan.

The home health aide can help with bathing, dressing, and toileting, but only if a nurse or therapist is also visiting you for a skilled service. Medicare will not pay for an aide to come to your home solely to help with personal care. Durable medical equipment — a walker, hospital bed, oxygen, or diabetic supplies — is covered separately under Part B if your doctor prescribes it.

Services like meal delivery, housekeeping, yard work, or transportation to appointments are not covered. Neither is custodial care — ongoing help with activities of daily living when no skilled service is being provided. If you need those services, you may pay out of pocket, turn to Medicaid (which has different rules by state), or look into programs run by your local Area Agency on Aging.

How to start home health care through Medicare

The process begins with your doctor. Tell your doctor you want to receive care at home, and ask whether home health care is medically necessary for your condition. Your doctor will write an order for home health services and state that you are homebound — meaning you cannot leave home without considerable and taxing effort, or you need supportive information to leave. Some people are not homebound but have severe difficulty leaving; Medicare may cover them too, though the rules are stricter.

Your doctor can refer you to a specific Medicare-certified home health agency, or you can search for one yourself using the Medicare Care Compare tool at Medicare.gov. Enter your zip code and the tool will show you which agencies in your area are certified, their quality ratings, and whether they accept Medicare. Call the agency and tell them your doctor has ordered home health care; they will contact your doctor to get the full order and start scheduling visits.

The agency will send a nurse to your home for an initial assessment. This visit is free and does not commit you to anything. The nurse will review your medical history, check your home setup, and confirm that the care ordered by your doctor is appropriate. If everything checks out, visits will begin within a few days. You should receive a written plan of care that explains what services you will receive, how often, and for how long.

What you pay for home health care under Medicare

If the home health agency is Medicare-certified and the services are ordered by your doctor and deemed medically necessary, you pay nothing. Medicare Part A covers the first 60 days of home health care after a hospital or skilled nursing facility stay. Part B covers home health care even if you have not been hospitalized, as long as the other conditions are met.

You do not pay a copay, coinsurance, or deductible for covered home health services. However, if you receive durable medical equipment through the agency — such as a wheelchair or oxygen — you may owe 20 percent coinsurance under Part B after you meet your annual deductible. If the agency provides services that are not covered — such as housekeeping or meal prep — they must tell you in writing before they provide them, and you will be responsible for the full cost.

If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may differ. Medigap plans may cover some costs that Original Medicare does not. Medicare Advantage plans have their own networks and rules; check your plan documents or call your plan to confirm what home health services are covered and whether you need prior authorization.

How long Medicare covers home health care

There is no set time limit. Medicare will continue to cover home health care as long as your doctor orders it, you remain homebound, and the services remain medically necessary. Some people receive home health care for a few weeks after surgery; others receive it for months or years if they have a chronic condition that requires ongoing skilled nursing or therapy.

Your home health agency must recertify your care every 60 days. This means your doctor will review your progress and either continue the order or discharge you from home health. If you improve and no longer need skilled care, or if you become able to leave home without considerable effort, Medicare will stop covering the service. You can always ask your doctor to restart home health care later if your condition changes.

Finding a Medicare-certified home health agency

Start with the Medicare Care Compare tool at Medicare.gov. You can search by zip code and see which agencies are certified, their inspection results, staffing levels, and patient ratings. The tool also shows whether the agency offers the specific services you need — nursing, physical therapy, occupational therapy, or speech therapy.

Your doctor may have a preferred agency or may refer you to one. You are not required to use your doctor's referral; you can choose any Medicare-certified agency. Ask potential agencies whether they accept your insurance (Original Medicare, Medigap, or Medicare Advantage), how quickly they can start visits, and what their cancellation policy is. A good agency will answer your questions clearly and provide written information about their services and costs.

If you have trouble finding an agency or have questions about coverage, you can call 1-800-MEDICARE (1-800-633-4227). The line is free and available 24 hours a day, seven days a week. Representatives can tell you which agencies are certified in your area and answer questions about what Medicare covers.

When Medicare does not cover home care

Medicare will not cover home health care if you are not homebound or do not have severe difficulty leaving home. It will not cover care that is not ordered by a doctor or that is not medically necessary. It will not cover personal care, housekeeping, yard work, or meal preparation unless they are part of a skilled nursing or therapy visit.

If you need ongoing personal care but do not may have access to for Medicare home health, you have other options. Medicaid covers personal care services in many states, though rules vary widely. Veterans Affairs offers Aid and Attendance benefits to may be able to access veterans. Older Americans Act programs run by your local Area Agency on Aging may offer subsidized housekeeping or meal delivery. You can find your local Area Agency on Aging by calling the Eldercare Locator at 1-800-677-1116.

Frequently Asked Questions

Do I have to be hospitalized first to get Medicare home health care?

No. Medicare Part A covers home health care after a hospital or skilled nursing facility stay, but Part B covers it even if you have never been hospitalized. The requirement is that your doctor orders it and you are homebound or have severe difficulty leaving home. Many people receive home health care after an illness or injury treated at home.

Can I choose which home health agency I use?

Yes. You can use an agency your doctor refers you to, or you can search for a Medicare-certified agency yourself using the Medicare Care Compare tool. You are not required to use your doctor's choice. Make sure any agency you choose is Medicare-certified and accepts your insurance.

What happens if I improve and no longer need home health care?

Your doctor will discharge you from home health services. If your condition changes later and you need care again, your doctor can order it again. There is no penalty for being discharged and restarting; Medicare will cover it as long as the medical need is there.

Does Medicare cover a live-in caregiver or housekeeper?

No. Medicare does not cover personal care attendants, housekeepers, or live-in caregivers. If you need ongoing personal care, ask your doctor about Medicaid, which covers personal care services in many states. You can also hire a caregiver privately and pay out of pocket, or look into programs through your local Area Agency on Aging.

Will my Medicare Advantage plan cover home health care the same way?

Medicare Advantage plans must cover the same home health services as Original Medicare, but they may have different rules about which agencies you can use, whether you need prior authorization, or what you pay. Check your plan documents or call your plan to confirm coverage before you start services.