Medicare does not cover Visiting Angels or similar private home care companies
Visiting Angels is a private home care franchise that provides non-medical information — help with bathing, dressing, meal preparation, and companionship. Medicare does not pay for these services. If you use Visiting Angels, you pay out of pocket, usually between $20 and $30 per hour depending on your location and the type of care.
Medicare does cover some in-home care, but only specific types under strict conditions. The confusion arises because Medicare's home health benefit sounds similar to what Visiting Angels offers, but the two are entirely different. Medicare home health is medical care ordered by a doctor — skilled nursing, physical therapy, occupational therapy — delivered by a Medicare-certified agency. Visiting Angels provides custodial care, which Medicare never covers, regardless of how long you need it.
If you are looking for help at home and think Medicare might pay, you need to know which type of care you actually need and which program might cover it. This guide explains what Medicare does and does not pay for, and what your actual options are.
Key Takeaways
- Medicare does not cover Visiting Angels or any private home care company that provides bathing, dressing, meals, or companionship.
- Medicare home health covers only skilled nursing and therapy services ordered by a doctor, and only while you are homebound and the care is medically necessary.
- Medicare home health typically lasts a few weeks to a few months, not indefinitely, and ends when you no longer need skilled care or can leave home safely.
- If you need ongoing custodial care, Medicaid (not Medicare) may cover it in some states, or you pay privately or use long-term care insurance.
- The type of care you need — medical versus non-medical — determines which program, if any, will pay.
What Medicare home health actually covers and for how long
Medicare home health is a benefit that pays for skilled nursing, physical therapy, occupational therapy, and speech therapy delivered at home. A doctor must order the care, and you must be homebound — meaning you cannot leave home without considerable effort or help. The care must be medically necessary, not just convenient.
How long Medicare pays depends on your condition and progress. There is no fixed time limit. Some people receive home health for two weeks after surgery; others receive it for several months after a stroke. Medicare continues to pay as long as you meet three conditions: you are homebound, a doctor has ordered the care, and the care is skilled (meaning it requires a nurse or therapist, not just a home aide).
Once you can leave home safely or no longer need skilled care, Medicare stops paying. If you still need help at home — with bathing, meals, or dressing — you must pay out of pocket or use another program. This is the point where many people turn to Visiting Angels or similar services, or they explore Medicaid if they may have access to.
The difference between skilled care and custodial care
Medicare distinguishes between skilled care and custodial care. Skilled care requires the judgment of a nurse or therapist — wound dressing, medication management, physical therapy, speech therapy. Custodial care is help with activities of daily living — bathing, dressing, toileting, eating, grooming. Medicare pays for skilled care; it never pays for custodial care, no matter how long you need it.
Visiting Angels provides custodial care. Their staff help with bathing, dressing, meal preparation, light housekeeping, and companionship. These are not skilled services. Even if you need this help for the rest of your life, Medicare will not pay for it. This is true whether you receive the care at home, in an assisted living facility, or in a nursing home.
The distinction matters because it determines your options. If you need skilled care, Medicare home health may cover it for a defined period. If you need custodial care, you need a different funding source: Medicaid, long-term care insurance, savings, or family help.
When Medicare home health ends and what happens next
Medicare home health ends when your doctor determines you no longer need skilled care or when you are no longer homebound. This might happen after you recover from surgery, after a course of physical therapy, or when your condition stabilizes and you can manage at home with only non-medical help.
When home health ends, you have several options depending on your situation and finances. If you still need non-medical help at home, you can hire a private home care company like Visiting Angels and pay out of pocket. If you have long-term care insurance, it may cover some or all of the cost. If your income and assets are low enough, you may may have access to for Medicaid, which covers custodial care in some states.
Some people transition from Medicare home health to adult day programs, assisted living, or a nursing home. Others manage with family help or a combination of paid and unpaid care. The key is planning before Medicare home health ends, because the transition can happen quickly once your doctor determines you no longer need skilled care.
Medicaid coverage for in-home care if you may have access to
If you do not have the money to pay for Visiting Angels or similar services, Medicaid may cover custodial care at home in your state. Medicaid is a joint federal-state program, and coverage varies significantly. Some states cover in-home custodial care generously; others cover it minimally or not at all.
To may have access to for Medicaid, your income and assets must fall below your state's limits. These limits are much lower than Medicare's — typically around $1,000 to $2,000 in countable assets and $1,000 to $1,500 in monthly income, though rules vary by state and program. If you may have access to, Medicaid can cover home health aides, personal care attendants, and related services for as long as you need them.
The process of explore for Medicaid and determining what it covers in your state takes time and involves paperwork. Contact your state Medicaid office or a local Area Agency on Aging to learn what is available where you live and what the income and asset limits are. Some people spend down their assets to become Medicaid-may be able to access, but this requires careful planning with an elder law attorney to avoid penalties.
Private payment and long-term care insurance options
If you do not may have access to for Medicaid and Medicare does not cover the care you need, you pay out of pocket. Visiting Angels and similar agencies typically charge $20 to $30 per hour, though rates vary by location and whether you need care during evenings, weekends, or overnight. A person needing eight hours of care per day could spend $5,000 to $7,000 per month.
If you have long-term care insurance, it may cover some or all of this cost. Long-term care policies vary widely in what they cover, how much they pay per day, and how long they pay. If you have a policy, review it or contact your insurance agent to understand what in-home care is covered and what the daily or monthly benefit is.
If you do not have insurance and cannot afford private pay, explore whether your state's Medicaid program covers in-home care, whether you may have access to for any veteran benefits if you served in the military, or whether local nonprofits offer subsidized care. Some Area Agencies on Aging maintain lists of low-cost or sliding-scale home care providers in your area.
How to plan before Medicare home health ends
If you are currently receiving Medicare home health, ask your nurse or therapist when the doctor expects the care to end. Ask what will happen next and whether you will still need help at home. If you will, start planning now rather than waiting until the last week of coverage.
Contact your state Medicaid office to learn whether you might may have access to and what the process is. If you have assets, consult an elder law attorney about whether Medicaid planning makes sense for your situation. If you have long-term care insurance, review the policy and contact the insurer to understand what it covers. If you plan to pay privately, get quotes from home care agencies in your area and understand what the ongoing cost will be.
Talk to your family about what help they can provide and what you will need to pay for. The transition from Medicare-covered care to self-pay or Medicaid-covered care is often abrupt, and planning ahead prevents a crisis when the coverage ends.
Frequently Asked Questions
Can Medicare pay for Visiting Angels if my doctor orders it?
No. Visiting Angels provides custodial care — help with bathing, dressing, and meals — which Medicare never covers, even with a doctor's order. Medicare only covers skilled nursing and therapy services. If your doctor thinks you need help at home, Medicare may cover skilled nursing or therapy, but not the type of personal care Visiting Angels provides.
Does Medicare cover home health aides?
Medicare covers home health aides only as part of a skilled home health plan ordered by a doctor. The aide must work under the supervision of a nurse or therapist, and the visits must be tied to a skilled service like wound care or physical therapy. Once skilled care ends, Medicare stops paying for the aide, even if you still need help with bathing or dressing.
What if I need in-home care after Medicare home health ends?
You have three main options: pay out of pocket for a private agency like Visiting Angels, use long-term care insurance if you have it, or explore for Medicaid if your income and assets are low enough. Some states' Medicaid programs cover in-home custodial care; others do not. Contact your state Medicaid office to learn what is available.
How do I know if I am homebound for Medicare home health?
You are homebound if leaving home requires considerable effort or help from another person. This might mean you cannot walk without a walker, you become short of breath with minimal activity, or you are recovering from surgery and your doctor has restricted your movement. Your doctor and the home health agency determine whether you meet this requirement.
Can I use Visiting Angels while I am on Medicare home health?
Yes, you can hire Visiting Angels at the same time you receive Medicare home health. Medicare pays for the skilled services; you pay out of pocket for the custodial care. Some people do this because Medicare home health may only visit a few times per week, but they need daily help with bathing or meals.