Medicare Does Not Cover Visiting Angels Services
Medicare does not pay for Visiting Angels or any other private home care agency. Visiting Angels is a for-profit franchise that provides non-medical in-home care — help with bathing, dressing, meals, and companionship — and Medicare does not cover those services under any of its parts (Original Medicare, Medicare Advantage, or Medigap plans).
Medicare covers skilled nursing care and physical therapy at home only when ordered by a doctor and delivered by a licensed nurse or therapist. It does not cover personal care or companionship, which is what Visiting Angels provides. If you need in-home help with daily tasks, you will pay Visiting Angels out of pocket, or you may find coverage through Medicaid, a long-term care insurance policy, or a Veterans benefit if you may have access to.
Key Takeaways
- Medicare does not pay for Visiting Angels or other private home care agencies that provide personal care and companionship.
- Medicare covers only skilled nursing and therapy at home when a doctor orders it and a licensed professional delivers it.
- Medicaid may cover in-home personal care in your state, and coverage rules vary widely by location.
- Long-term care insurance, Veterans benefits, and out-of-pocket payment are the main ways people pay for Visiting Angels services.
- If you need skilled care at home, ask your doctor for a home health referral to see what Medicare will cover.
What Medicare Covers at Home vs. What It Does Not
Medicare Part A covers skilled nursing care and skilled therapy at home when three conditions are met: a doctor orders it, you have been in a hospital or skilled nursing facility for at least three days, and the care is for a condition related to that hospital or facility stay. A licensed nurse or therapist must deliver the care. This covers wound care, medication management, physical therapy, and occupational therapy.
Medicare does not cover custodial care — help with bathing, dressing, toileting, eating, and moving around — even if you need it every day. Visiting Angels provides custodial care. Neither does Medicare cover companionship, meal preparation, housekeeping, or transportation, which are also part of what Visiting Angels offers. If you need only those services, Medicare will not pay.
If you need both skilled care and personal care, Medicare will pay for the skilled portion only. You would pay Visiting Angels or another agency for the personal care part. Some people hire an agency to provide both services and split the cost between what Medicare covers and what they pay themselves.
When Medicaid Might Cover In-Home Care Instead
Medicaid is a joint federal and state program that does cover in-home personal care in most states, but the rules are different in every state and the program is means-tested — you must have low income and limited assets to may have access to. Some states call this service "personal care information" or "home care services." Others offer it only to people over 65 or only to people in certain disability categories.
To find out whether your state's Medicaid program covers in-home personal care and what the income and asset limits are, contact your state Medicaid office or call 211 and ask for a Medicaid referral. If you already receive Medicaid, your caseworker can tell you what in-home services are covered in your state. Medicaid coverage is usually more generous than Medicare for personal care, but the process process is longer and the income limits are strict.
Some states offer Medicaid waiver programs that let people receive in-home care instead of moving to a nursing facility. These waivers have waiting lists in many states, sometimes years long. If you think you may may have access to for Medicaid, it is worth asking about waiver programs in your area even if the wait is long, because your name can go on the list while you explore other options.
Long-Term Care Insurance and Other Payment Options
If you have a long-term care insurance policy, check your policy documents or call your insurance company to see whether it covers in-home personal care. Many long-term care policies do cover Visiting Angels or similar agencies, though the daily or monthly benefit amount may be limited. Some policies require you to meet a waiting period or a certain level of care need before benefits start. If you have this type of policy, it is often the fastest way to pay for Visiting Angels without using Medicaid.
Veterans and their surviving spouses may be able to pay for Visiting Angels through the Aid and Attendance benefit, a monthly payment from the Department of Veterans Affairs. This benefit is not a direct payment to the agency — it is a monthly stipend to you — but it can be used to pay for in-home care. The benefit amount varies and the process process takes several months. Contact the VA or a Veterans service officer to learn whether you may have access to.
Many people pay for Visiting Angels out of pocket. Costs vary by location and the level of care needed, but typically range from $20 to $30 per hour for non-medical personal care. Some agencies offer discounts for regular, ongoing care. If cost is a barrier, ask Visiting Angels whether they offer sliding scale fees or payment plans, or explore whether a local Area Agency on Aging has lower-cost alternatives.
How to Get a Home Health Referral from Medicare
If you think you need in-home care and you are not sure whether it is skilled care (which Medicare might cover) or personal care (which it will not), ask your doctor for a home health referral. Your doctor can order a home health nurse to visit and assess what you need. If the assessment shows you need skilled nursing or therapy, Medicare will cover those visits. If it shows you need only personal care, the nurse will tell you that, and you can then explore Medicaid, long-term care insurance, or private payment.
To request a home health referral, call your doctor's office and say you need help at home and want to know whether Medicare will cover it. The doctor does not have to order home health — you can also ask for a referral to a social worker or case manager who can help you figure out what you need and what options are available. Many hospitals have social workers on staff who do this work for free.
Frequently Asked Questions
Does Medicare Advantage cover Visiting Angels?
No. Medicare Advantage plans must cover everything Original Medicare covers, and Original Medicare does not cover personal care agencies like Visiting Angels. Some Medicare Advantage plans offer supplemental benefits like transportation or meal delivery, but not in-home personal care from a private agency. Check your plan documents or call your plan to confirm what supplemental benefits you have.
If I have a Medigap policy, will it cover Visiting Angels?
No. Medigap policies pay for costs that Original Medicare does not cover — like copays and coinsurance — but they do not cover services that Medicare itself does not cover. Since Medicare does not cover personal care, Medigap will not either. A long-term care insurance policy is different and may cover Visiting Angels, but Medigap will not.
Can I use my Medicare savings to pay for Visiting Angels?
Yes. If you have money in a Medicare Savings Account or any other savings, you can use it to pay Visiting Angels out of pocket. There is no rule against this. However, if you are thinking about explore for Medicaid to cover in-home care, having too much in savings may disqualify you, so talk to a Medicaid caseworker before spending down your savings.
What if my doctor says I need help at home but I cannot afford it?
Tell your doctor that cost is a barrier. Ask for a referral to a social worker or case manager who can help you explore Medicaid, Veterans benefits, or local programs that may help. You can also call 211 and ask for information about in-home care resources in your area. Some communities have programs that provide free or low-cost help with personal care.
Does Medicare cover home health aides from an agency?
Medicare covers home health aides only when they are part of a skilled care plan ordered by a doctor — for example, a home health aide helping a nurse with wound care or helping you move safely after surgery. Medicare does not cover aides who provide only personal care. If you need an aide for personal care only, you would pay out of pocket or through Medicaid, long-term care insurance, or a Veterans benefit.