[Last updated October 22, 2025]
Home health care can be a lifeline for people recovering from illness, injury, or surgery after a hospital stay. Many older adults may wonder if Medicare covers home health care. Medicare does cover home health care, but only under specific conditions.
Fully understanding the rules will help you get the supportive care you need without the risk of your insurer denying coverage later. Here, we will discuss when and how Medicare covers home health care services to help you recover.
What is Medicare?
Medicare is the federal health insurance program for people age 65 and older, and for some younger individuals with disabilities or specific medical conditions. It’s divided into several parts:
- Part A (hospital insurance) covers inpatient hospital care, skilled nursing, and some home health services.
- Part B (medical insurance) covers doctor visits, outpatient care, medical equipment, and other services.
- Part C (Medicare Advantage) is an alternative to original Medicare Parts A and B (and sometimes Part D). These plans are provided by private insurers and must include at least the same coverage of Parts A and B, often with extra benefits.
- Part D is prescription drug coverage.
Home health care benefits fall under Part A and Part B if you have original Medicare or under Part C if you have a Medicare Advantage plan.
What is home health care?
Home health care provides skilled medical services delivered at home for people recovering from an illness, an injury, or surgery or who are managing chronic health conditions. It’s designed to help you regain independence and avoid or shorten hospital stays.
Professionals who provide home health care include:
- Registered nurses and licensed practical nurses.
- Physical, occupational, or speech therapists.
- Medical social workers.
Services may include:
- Pain management.
- Monitoring vital signs.
- Wound care.
- Physical, occupational, or speech therapy.
- Medication management.
Home health care vs. home care
It’s easy to confuse home health care with home care, but Medicare makes a clear distinction between the two.
| Home health care (covered by Medicare) | Home care (not covered by Medicare) |
| Medical care ordered by a doctor | Personal help, such as assistance with bathing, dressing, or meals |
| Provided by nurses or therapists | Provided by caregivers or aides |
| Focused on recovery or rehabilitation | Focused on daily living assistance |
| Time-limited and medically necessary | Ongoing and nonmedical |
Note that Medicare may cover some home care services, but only when a doctor deems it medically necessary while the individual is also receiving medical home health care, and only for a short time.
When might someone need home health care?
Doctors often prescribe home health care after an event that makes leaving home difficult or unsafe. Common examples include:
- After surgery, when wounds or stitches need care.
- Following hospitalization for heart failure or pneumonia.
- After a stroke, to regain speech or mobility.
- While managing chronic conditions like diabetes or COPD.
Here’s an example: After a hip replacement, 78-year-old Ellen returned home but needed help walking safely and managing wound care. Her doctor ordered home health care, allowing a nurse and physical therapist to visit several times a week. Medicare paid for these services because they were medically necessary and part of Ellen’s recovery plan, but only until they were no longer required.
Home health care can also follow care in a skilled nursing facility (SNF).
Another possible scenario: John is hospitalized with pneumonia for five days. He then spends two weeks in a skilled nursing facility for nursing and physical therapy because he cannot safely manage at home. Once his condition stabilizes, he still needs physical therapy and help with medication management at home. His doctor arranges home health care, and a Medicare-approved agency provides Medicare-paid visits.
What home health care services does Medicare cover?
We can divide the skilled care covered by Medicare into two categories: medical and therapeutic services, and supportive medical services. Examples of what falls into each category may help you understand exactly what is covered.
Medical and therapeutic services may include:
- Skilled nursing (part-time or intermittent).
- Wound or post-surgical care.
- IV therapy, injections, or medication management.
- Physical, occupational, or speech therapy.
- Monitoring vital signs and progress on a treatment plan.
Supportive medical services may include:
- Home care aide visits (to help with bathing, dressing, or mobility, but only when tied to your home health care plan).
- Medical social services to connect you with community or recovery resources.
- Supplies related to your treatment, such as wound dressings.
- Durable medical equipment, like walkers, oxygen, or wheelchairs (typically 80% covered under Part B).
Home health care benefits are designed to support your recovery for a limited time.
Note: Medicare Advantage plans must cover these services at least as generously as original Medicare, though copays and network rules may differ.
What home health services are not covered?
Medicare does not pay for ongoing or nonmedical services that are considered custodial care, which falls outside the skilled care definition.
Common examples include:
- 24-hour care or live-in caregivers.
- Housekeeping, laundry, or meal delivery.
- Long-term personal care unrelated to a medical treatment plan.
- Medication refills or drugs you can take on your own.
- Private-duty nursing not ordered by your doctor.
As mentioned above, under certain circumstances, Medicare may cover nonmedical home care (personal care) if a doctor determines that it is medically necessary. In this case, the individual must also be prescribed medical home health care, and Medicare will cover it only for a short time.
If you need these types of services, you can explore paying privately, through Medicaid, or through long-term care insurance.
How long does Medicare cover home health care?
There’s no fixed day limit for Medicare-covered home health care. Coverage continues as long as the care remains medically necessary and you continue to meet eligibility requirements.
The home health agency must review your condition regularly and recertify your need for continued services every 60 days.
Deductibles, costs, and limits
Costs for home health care depend on whether you have original Medicare or a Medicare Advantage plan. Always confirm with your plan or agency before services begin.
| Expense type | Original Medicare (Parts A and B) | Medicare Advantage (Part C) |
| Deductible | Part A deductible (projected at $1,716 for 2026) applies first to the hospital stay and typically would be fully met there; Part B deductible (projected at $288 for 2026) applies similarly | Varies by plan; check your summary of benefits |
| Copayment | No copay for covered home health visits; 20% for durable medical equipment under Part B without Medigap | Varies by plan; may include copays or coinsurance |
| Visit limits | No fixed day limits; must remain medically necessary | Plan rules vary; coverage must meet medical necessity and network requirements |
| Lifetime/annual maximum | None for covered services | Varies by plan |
Always confirm with your home health agency and Medicare plan which costs you may be responsible for to avoid unexpected bills.
How does billing work?
Medicare makes the process straightforward.
- A health care provider assesses you face-to-face before certifying that you need home health services.
- Your doctor orders home health care, approves a care plan, and may provide a list of agencies that serve your area.
- The home health agency confirms eligibility, provides services, and submits claims directly to Medicare.
- You show your Medicare card, and the agency bills Medicare, not you.
- If you have a Medicare Advantage plan, you’ll follow your plan’s provider network and billing rules.
