Original Medicare (Medicare Part A and Part B) does cover some limited home health services. Some of the eligible home health services include:
- Part-time skilled nursing care
- Part-time home health aide care
- Medical social services
- Physical and occupational therapy
- Speech-language pathology services
Home health services are typically covered only if they are considered medically necessary by your doctor. A home health care agency can help you coordinate your home health services.
What home health care does Medicare NOT cover?
Medicare does not typically cover:
- 24-hour-a-day care at home
- Homemaker services
- Meal delivery
- Custodial or personal care such as help with dressing or bathing, if that is the only care you need
Who is eligible for Medicare home health care?
Generally, anyone enrolled in Medicare Part A and/or Part B who meets the following conditions can have their home health care covered by Medicare:
- A doctor certifies that you are homebound
- You are under the care of a doctor
- A doctor certifies that you require one or more of the following:
- Part-time skilled nursing care
- Physical therapy, speech-language pathology, or occupational therapy services
Home health services are only covered by Medicare when they are specific, safe and an effective treatment for your health condition.
Home health care costs with Medicare
Even if your home health care services are covered by Medicare, you may have to pay some money out of pocket.
Typically, you’ll pay $0 for Medicare-covered home health care services and 20% of the Medicare approved amount for durable medical equipment (DME).
Ask your home health agency how much Medicare will pay before you begin receiving home health care. This can help prevent you from being surprised by unexpected out-of-pocket costs.
Medicare Advantage plans can cover home health care services
Medicare Advantage plans combine the benefits covered by Medicare Part A and Part B into one single plan sold by a private insurance company. Many Medicare Advantage plans may also offer some additional benefits not covered by Original Medicare, such as dental care and prescription drug coverage.
Medicare Advantage plans cover the same home health care services that are covered by Medicare Part A and Part B. Starting in 2019, some Medicare Advantage plans may begin offering an expanded list of benefits that could potentially include:
- Grab bars in home bathrooms
- Healthier food options
- Air conditioners for people with asthma
- Home-delivered meals
- Aides to help with daily activities like dressing or eating
Learn more about Medicare Advantage plans and find out if these benefits might be right for you. To compare plans in your area, speak with a licensed insurance agent by calling TTY Users: 711 24 hours a day, 7 days a week.
