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Does Medicare cover in-home health care services?

An in-home health care aide helps an older woman understand what in-home health care services Medicare covers

Medicare often pays for in-home assistance, but it can depend on the type of care, why the care is needed and how long the in-home assistance is projected to last. Some in-home health care services can be more affordable and convenient ways to get the care you need. 

If you have a condition which makes it harder to be out and about, in-home care can be especially essential to your overall well-being. Here’s what to know about Medicare coverage and in-home health care services. 

What home health care services are covered by Medicare?

For a home health care service to be covered by Medicare, it must first be ordered by a doctor. You also must receive your home health care from one of the home health agencies that has been certified by Medicare.

Skilled Nursing Care

Services such as changing wound dressings, injecting medicine or feeding through a tube are types of skilled nursing care services that would be covered by Medicare. Skilled nursing care that’s provided on a part-time basis will most likely be covered by Medicare. 

Physical, Occupational, and Speech Therapy

Physical, occupational and speech therapies needed to restore or improve function for everyday tasks, such walking or speaking in the aftermath of an injury or illness are most likely covered by Medicare. 

Home Health Aide Services

Home health aides that assist with daily activities such dressing, bathing or going to the bathroom are typically covered by Medicare if such care is necessary due to an illness or injury. 

Medical Social Services

Social services such as counseling for social or emotional concerns related to an injury or illness are usually covered by Medicare.

Medical Supplies

Medical supplies such as wound dressings or catheters that are related to an injury or condition will likely be covered by Medicare as long as an approved home health agency provides them. Medical equipment such as wheelchairs and walkers might also be included in coverage, but Medicare will not always cover the full cost.

What home health care services are NOT covered by Medicare?

Medicare often does not cover 24-hour-a-day care at home, meal delivery to your home, homemaker services and personal care, when these are the only forms of care needed. Non-skilled home care, which is care not provided by nurses, doctors or other licensed medical personnel, is also not covered under Original Medicare. However, non-skilled home care is often included as a supplemental benefit in Medicare Advantage plans

How long does Medicare pay for home health care services?

Medicare can pay the full cost of home health care services for 60 days at a time. Every 60 days, your doctor will have to recertify the care as medically necessary in order for Medicare to continue coverage. 

The Benefits of In-Home Health Care Services

In-home health care is a great way to receive individualized healthcare services in the comfort of your own home. In comparison to nursing homes, rehabilitation centers or other institutionalized care facilities, in-home health care can be cost-effective, as there is no need for room and board costs. Home health care agencies can assess your needs and develop a care plan that reinforces and supports the care you receive from friends and family, and works for your lifestyle. 

How To Qualify for Home Health Care

In order for Medicare Part A and/or Part B to cover home health services, there are a few conditions you must meet:

  • You must be under the care of a doctor, and you must be receiving services under a plan of care created and reviewed regularly by a doctor.
  • Physical therapy, speech-language pathology, or continued occupational therapy services are covered when the services are specific, safe and an effective treatment for your condition. 
  • You must be homebound, and a doctor must certify that you’re homebound.1

Review Your Medicare Coverage and Home Health Care Services

Taking the time to review your Medicare coverage is important not only for your health but also for your budget. Navigating all your Medicare options can be time-consuming and confusing, but the good news is that we can help you sort through all your options, making sure you’re receiving the benefits and coverage available at a price that works for you.

1 https://www.medicare.gov/coverage/home-health-services

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