Medicare covers home health care for as long as your doctor says you need it, but only if you meet specific conditions

Medicare Part A (hospital insurance) pays for home health care when a doctor orders it because you are homebound and need skilled nursing or therapy. There is no set time limit — Medicare will keep paying as long as your condition requires it and you continue to meet the rules. However, coverage stops the moment you no longer need skilled care, you can leave home safely, or you stop using the services.

The length of coverage depends entirely on your medical situation, not on a calendar. Someone recovering from hip surgery might need home health for four weeks. Someone managing a chronic wound or learning to use new equipment might receive it for months. The key is that a doctor must certify every 60 days that you still need the care.

Key Takeaways

  • Medicare has no maximum number of days or visits for home health care — you can receive it as long as your doctor orders it and you meet the homebound requirement.
  • A doctor must recertify your need for home health care every 60 days, and coverage stops if that certification is not renewed.
  • You must be homebound, meaning leaving home requires considerable and taxing effort, and you cannot receive home health for routine checkups or preventive visits.
  • Home health agencies must be Medicare-certified, and you pay nothing out of pocket for covered services when you have Part A.
  • If you no longer need skilled care but still need help at home, Medicare does not cover personal care or housekeeping, though other programs may.

What "Homebound" Means and Why It Matters

To receive Medicare home health care, you must be homebound — meaning you cannot leave home without help and leaving would be medically risky or require considerable effort. This does not mean you never leave your house. It means you leave rarely, only with help, and only for medical appointments or essential tasks like getting groceries with information.

If you can get in a car and go to a doctor's office on your own, or if you can walk to a neighbor's house without risk, Medicare will likely say you are not homebound and will stop paying for home health. The agency and your doctor assess this together. They look at whether you use a walker or wheelchair, whether you have severe pain when moving, whether you are at risk of falling, and whether a medical condition makes leaving dangerous.

This rule exists because Medicare distinguishes between skilled care (nursing, physical therapy, wound care) and personal care (help bathing, dressing, or eating). Home health covers the first; it does not cover the second, even if you are homebound.

The 60-Day Recertification Cycle

Every 60 days, your doctor must sign a form saying you still need home health care and still meet the homebound requirement. This is not automatic. Your home health agency will ask your doctor to recertify, but if the doctor does not respond or says you no longer need care, Medicare stops paying when ready.

You should receive notice before the 60 days are up. If you do not hear from your agency about recertification, call them and ask whether your doctor has signed the paperwork. If your doctor says you no longer need home health, you have the right to ask why and to request a second opinion from another doctor. Medicare will not pay for home health while you are disputing the decision, but you can appeal once the coverage ends.

Some people need home health for years because their condition does not improve — for example, someone with advanced Parkinson's disease or ALS who needs ongoing nursing care. Others need it for weeks or months while they recover. The recertification process straightforward confirms that the need is still there.

What Services Medicare Home Health Covers

Medicare pays for skilled nursing (wound care, medication management, monitoring), physical therapy, occupational therapy, speech therapy, and medical social work when ordered by a doctor. It also covers medical equipment like hospital beds, wheelchairs, and oxygen, and supplies like bandages and catheters. You pay nothing out of pocket for these services when you have Part A.

Medicare does not cover personal care (help bathing or dressing), housekeeping, meal preparation, or transportation to appointments. If you need these services, you may pay out of pocket, use Medicaid if you may have access to, or look into local senior programs. Some home health agencies offer these services privately, meaning you pay them directly rather than billing Medicare.

The home health agency must be Medicare-certified. You can check whether an agency is certified by calling 1-800-MEDICARE or visiting Medicare.gov. Using a non-certified agency means Medicare will not pay, and you will owe the full cost.

When Medicare Home Health Coverage Ends

Coverage stops when your doctor says you no longer need skilled care, when you are no longer homebound, when you move to a nursing home or hospital, or when you stop using the services. It also stops if you do not pay any copayments you owe (though Medicare-covered home health has no copayment for Part A beneficiaries) or if you move out of the agency's service area.

If your condition improves and you no longer need skilled nursing or therapy, that is good news — it means you are recovering. However, you may still need help at home. Talk to your doctor or social worker about other options: adult day programs, Meals on Wheels, transportation services, or hiring a home aide privately. Some of these are free or low-cost through local aging agencies.

If you disagree with the decision to end home health, you can appeal. You have the right to continue receiving services while your appeal is being decided, though you may owe the cost if Medicare ultimately agrees with the decision to stop coverage.

Paying for Home Health Care Beyond Medicare

If you need help at home but do not meet Medicare's homebound requirement or no longer need skilled care, other programs may help. Medicaid covers personal care and housekeeping in most states if your income is low enough. Veterans Affairs offers Aid and Attendance benefits for may be able to access veterans. Some states have programs that pay for in-home support for seniors with low incomes.

You can also hire a home aide privately. Costs vary widely by region and the aide's training, but typically range from $20 to $30 per hour for basic personal care. Some people use a combination: Medicare pays for skilled nursing, and they pay out of pocket for a housekeeper or personal care aide.

Your local Area Agency on Aging can tell you what programs exist in your area. You can find yours by calling 1-800-677-1116 or visiting Eldercare Locator online.

Questions to Ask Your Doctor About Home Health

Before home health starts, ask your doctor how long they expect you to need it, what specific services you will receive, and how often the agency will visit. Ask whether the agency is Medicare-certified and whether they accept your insurance. Ask what you should do if your condition changes or you have questions about the care.

Ask your doctor to explain why you are homebound and what would change that status — for example, "When you can walk 50 feet without pain" or "When you no longer need the walker." This helps you understand what recovery looks like and when coverage might end.

If your doctor says home health is ending, ask why and whether another type of care might help instead. Ask whether you can appeal the decision and what the process is.

Frequently Asked Questions

Can Medicare home health continue after I move to assisted living?

No. If you move to any facility where staff are available — including assisted living, independent living with services, or a nursing home — Medicare stops paying for home health. You may be able to receive services through the facility instead, or you may need to pay privately.

What happens if I miss a home health visit?

Missing one visit does not end your coverage. However, if you stop using services for an extended period without telling the agency, they may close your case. If you need to pause home health temporarily, tell your agency and doctor so they can restart it when you are ready.

Do I pay anything for Medicare home health care?

If you have Part A, you pay nothing for covered skilled nursing, therapy, or medical equipment. You may owe a copayment for certain supplies or equipment, but the agency will tell you upfront if that applies. Personal care or housekeeping services are not covered, so you would pay out of pocket if you want them.

Can I choose which home health agency Medicare uses?

Yes. Your doctor can order home health, but you choose the agency. Ask your doctor which agencies they recommend, check whether they are Medicare-certified, and call to ask about their experience with your condition. You can switch agencies if you are not satisfied, though you should tell both the old and new agency.

What if my doctor will not recertify home health?

You have the right to ask your doctor why and to request a second opinion from another doctor. You can also file an appeal with Medicare. Contact 1-800-MEDICARE to start an appeal, and ask whether you can continue receiving services while the appeal is being decided.