Quick Answer
Yes, Medicare covers home health care at no cost to you when you meet four criteria: (1) you are homebound, (2) you need skilled nursing care or therapy, (3) the care is ordered by a physician, and (4) the home health agency is Medicare-certified. Medicare does not cover non-skilled personal care (bathing, dressing) unless it is provided alongside skilled care.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Skilled Nursing Visits | Covered | Part-time or intermittent skilled nursing care ordered by a physician |
| Physical / Occupational / Speech Therapy | Covered | Medically necessary therapy services provided at home |
| Home Health Aide Services | Partial | Covered only when provided alongside skilled nursing or therapy |
| Medical Social Services | Covered | Covered when ordered by a physician as part of a care plan |
| Durable Medical Equipment | Covered | 80% covered by Part B; you pay 20% coinsurance |
| Non-Skilled Personal Care (custodial) | Not Covered | Bathing, dressing, meal prep without skilled care component |
| 24-Hour Home Care | Not Covered | Medicare does not cover around-the-clock home care |
Understanding Your Coverage Options
Medicare Home Health Coverage - Eligibility Requirements
Covered at no cost when all criteria are metMedicare covers home health care under both Part A and Part B. The same four eligibility criteria apply regardless of which part pays.
**You must be homebound.** This means leaving home requires a considerable effort due to illness or injury. You may still leave home for medical appointments, religious services, or adult day care without losing homebound status.
**You must need skilled care.** Medicare requires that you need skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy. Skilled care means services that can only be safely performed by or under the supervision of a licensed professional.
**A physician must order the care.** Your doctor must certify that you are homebound and need skilled care, and must establish a plan of care.
**The agency must be Medicare-certified.** The home health agency providing your care must be approved by Medicare.
What It Covers
- Skilled nursing visits (wound care, injections, monitoring, education)
- Physical therapy
- Occupational therapy
- Speech-language pathology
- Medical social services
- Part-time home health aide services (when provided with skilled care)
- Durable medical equipment (80% covered)
What It Doesn't Cover
- Non-skilled personal care (bathing, dressing, grooming) without skilled care
- 24-hour home care or live-in aides
- Homemaker services (cooking, cleaning, shopping)
- Meal delivery
Covered home health services: $0 cost to you. Durable medical equipment: 20% coinsurance after the $283 Part B deductible.
No Cost for Covered Home Health Services
Under Original Medicare, you pay $0 for covered home health services. You do not pay a deductible or coinsurance for skilled nursing visits or therapy. The only cost-sharing is 20% for durable medical equipment.
How Long Does Medicare Cover Home Health?
Covered as long as you remain eligibleThere is no set limit on the number of home health visits Medicare will cover. Medicare covers home health care as long as you continue to meet the eligibility criteria - you remain homebound, you need skilled care, and your physician certifies the ongoing need.
Medicare pays home health agencies in 30-day periods. Your physician must recertify your need for home health care at least every 60 days.
If your condition improves to the point where you no longer need skilled care or are no longer homebound, Medicare coverage ends. You have the right to appeal if you believe coverage was ended prematurely.
What It Covers
- Unlimited visits as long as eligibility criteria are met
- Multiple 30-day periods of care
- Recertification by your physician every 60 days
What It Doesn't Cover
- Care that is no longer medically necessary
- Care when you are no longer homebound
Know Your Rights
If a home health agency tells you Medicare will no longer cover your care, you have the right to a written notice (HHCCN) and the right to appeal. Do not accept a verbal denial - request the written notice and contact 1-800-MEDICARE if you disagree.
✦ Frequently Asked Questions
Jagger Esch
AuthorJagger Esch is the Medicare Educator at MedicareFAQ and the founder of Elite Insurance Partners.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare.