Medicare does cover home health care, but only under specific conditions. Most people are surprised to learn that when you qualify, Medicare pays 100% of approved home health services with no deductible and no copay. The catch is that Medicare covers skilled medical care at home, not ongoing personal care or help with daily tasks. Understanding the difference between what Medicare will and will not pay for can save you thousands of dollars and prevent gaps in care.
What Medicare Home Health Care Covers in 2026
Medicare covers home health services through both Part A and Part B. In most cases, Part B handles coverage. Part A may apply after a qualifying hospital stay of at least three days or following a covered skilled nursing facility (SNF) stay.
Covered services include:
- Skilled nursing care (wound care, IV therapy, injections, medication management, post-surgical monitoring)
- Physical therapy to restore or maintain function
- Occupational therapy to help with daily living skills
- Speech-language pathology for communication or swallowing issues
- Medical social services to help coordinate care and address social needs
- Part-time home health aide services when provided alongside skilled care
- Durable medical equipment (DME) at 80% coverage (you pay 20% after the Part B deductible of $257 in 2026)
One important note: home health aide services, like help with bathing or dressing, are only covered when you are already receiving skilled nursing or therapy services. Medicare will not pay for a home health aide as a standalone service.
The Four Requirements to Qualify
To receive Medicare home health benefits, you must meet all four of the following conditions.
1. You Must Be Homebound
Medicare defines "homebound" as a condition where leaving your home requires a considerable and taxing effort. You do not have to be bedridden. You qualify as homebound if:
- You need a wheelchair, walker, or cane to get around
- You need the help of another person to leave your home
- You have a medical condition that makes leaving home unsafe or inadvisable
You can still leave your home occasionally for medical appointments, religious services, or adult day care without losing your homebound status.
2. You Must Need Skilled Care
Medicare covers care that must be provided by or under the supervision of a licensed nurse or therapist. Skilled care includes things like wound debridement, post-surgical monitoring, learning to use a prosthetic, and certain injections. General help with bathing, meal prep, or companionship does not count as skilled care.
3. Your Doctor Must Certify the Need
A physician or other qualified healthcare provider (such as a nurse practitioner) must examine you, determine that you need home health care, and create a formal plan of care. They must also certify that you are homebound. This certification must be renewed regularly during the course of your care.
4. The Agency Must Be Medicare-Certified
You must receive care from a home health agency that is certified by Medicare and in good standing. If the agency is not Medicare-certified, Medicare will not pay, even if you meet all other requirements. The Medicare.gov Home Health Compare tool lets you search for certified agencies in your area.
What Medicare Does NOT Cover
Understanding what Medicare will not pay for is just as important as knowing what it covers.
| Not Covered by Medicare | Why |
|---|
| 24-hour home care | Medicare only covers intermittent or part-time care |
| Custodial care only | Personal care (bathing, dressing, grooming) without skilled services is excluded |
| Meal delivery or housekeeping | These are non-medical services |
| Full-time home health aide | Only covered alongside skilled nursing or therapy |
| Prescription drugs at home | Covered under Part D, not the home health benefit |
| Long-term care at home | Medicare is not a long-term care program |
Many families assume Medicare will cover a full-time caregiver at home. It will not. If your loved one needs ongoing personal care without any skilled medical need, Medicare will not pay for it. This is the gap that surprises most families and leads people to look at Medicaid or private long-term care insurance.
How Long Does Medicare Pay for Home Health Care?
Medicare does not set a fixed number of days or visits for home health coverage. As long as you continue to meet the eligibility requirements above, Medicare will continue to cover your care. Each episode of care lasts 30 days (under the 2020 Patient Driven Groupings Model). Your doctor and agency must recertify your eligibility at regular intervals.
There is no annual limit on the number of home health episodes you can receive. However, Medicare expects your condition to be improving or for the care to be necessary to maintain your current function.
Medicare Home Health Care Costs in 2026
| Service | Your Cost |
|---|
| Skilled nursing visits | $0 |
| Physical, occupational, or speech therapy | $0 |
| Home health aide (alongside skilled care) | $0 |
| Medical social services | $0 |
| Durable medical equipment (DME) | 20% after $257 Part B deductible |
There are no prior authorization requirements for Medicare home health. Your doctor writes the order and the certified agency begins providing care.
Medicare Advantage and Home Health
If you are enrolled in a Medicare Advantage plan (Part C) instead of Original Medicare, your plan must cover the same home health services as Original Medicare. However, your plan may:
- Require you to use in-network agencies
- Have different copays or prior authorization rules
- Offer additional home health benefits beyond what Original Medicare covers
Always check your specific plan documents or call your plan before arranging home health services to avoid unexpected costs.
Help Paying Medicare Costs: Medicare Savings Programs
If you have limited income and need help paying Medicare costs, Medicare Savings Programs (MSPs) can help. While home health visits under Original Medicare are already $0, MSPs can help cover your Part B premium (which is $185.00 per month in 2026), deductibles, and the 20% coinsurance on durable medical equipment.
2026 Medicare Savings Program Income Limits
| Program | Individual Monthly Income | Couple Monthly Income | What It Covers |
|---|
| Qualified Medicare Beneficiary (QMB) | Up to $1,350 | Up to $1,824 | Part A and B premiums, deductibles, copays |
| Specified Low-Income Medicare Beneficiary (SLMB) | Up to $1,616 | Up to $2,184 | Part B premium |
| Qualifying Individual (QI) | Up to $1,816 | Up to $2,455 | Part B premium |
| Qualified Disabled and Working Individual (QDWI) | Up to $4,615 | Up to $6,239 | Part A premium only |
Note: Some states set higher income limits than the federal baseline. You may qualify even if your income is above these figures depending on where you live.
Use our free benefits screener to check whether you qualify for a Medicare Savings Program and other assistance.
How to Get Medicare Home Health Care Started
Follow these steps to begin home health services under Medicare:
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Talk to your doctor. Tell your doctor you need home health care. They must examine you, confirm you are homebound, and order services as part of a formal care plan.
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Get a referral to a Medicare-certified agency. Your doctor or hospital discharge planner can recommend agencies. You can also search medicare.gov/care-compare to find certified agencies near you.
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Confirm the agency is Medicare-certified. Ask directly before starting care. The agency should be able to confirm their Medicare certification status.
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The agency conducts an assessment. A nurse or therapist from the agency will come to your home to assess your needs and create a care plan.
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Care begins. Once the plan is in place and your doctor signs off, the agency starts providing services. You should receive an Advance Beneficiary Notice (ABN) if Medicare might not cover a particular service.
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Monitor your Medicare Summary Notice (MSN). This document (mailed quarterly or available at mymedicare.gov) shows what Medicare has paid and flags anything that may need your attention.
If Medicare denies your home health claim, you have the right to appeal. Request a review in writing within 60 days of receiving the denial notice.
When to Look Beyond Medicare
If you or a family member needs care that Medicare will not cover, consider these options:
- Medicaid: For people with low income, Medicaid often covers personal care, home health aides, and long-term home services that Medicare excludes. Eligibility and covered services vary by state.
- Long-term care insurance: Private policies can cover custodial care costs that Medicare does not.
- Veterans benefits: VA home health programs are available to eligible veterans.
- State programs: Many states offer home care programs, personal care attendant services, and other assistance for older adults and people with disabilities.
Use our benefits screener to quickly check programs you may qualify for based on your income, household size, and situation.
Frequently Asked Questions
Does Medicare cover home health care with no cost to me?
Yes, for most covered services. Skilled nursing visits, therapy services, and home health aide services (when part of a skilled care plan) are covered at $0 under Original Medicare. The exception is durable medical equipment, where you pay 20% after your Part B deductible.
Does Medicare cover a full-time home caregiver?
No. Medicare only covers part-time or intermittent skilled care. If you need someone at home around the clock for personal care tasks, Medicare will not pay for that. Medicaid may cover it depending on your state and income.
What does "homebound" mean for Medicare purposes?
Homebound means that leaving your home requires a considerable and taxing effort due to illness or injury. You may use a wheelchair or walker, or need another person's help. You can still leave for medical appointments, religious services, or adult day programs without losing your homebound status.
Can I choose my own home health agency?
Yes. You have the right to choose any Medicare-certified home health agency in your area. Your doctor may recommend one, but the choice is yours.
How do I find a Medicare-certified home health agency?
Visit medicare.gov/care-compare and search by your ZIP code. The tool shows ratings, services offered, and quality data for certified agencies near you.
Does Medicare Advantage cover home health care the same way?
Medicare Advantage plans must cover at least the same home health services as Original Medicare. Many plans offer additional benefits. However, you may be required to use in-network agencies, and prior authorization may apply. Check your plan's Evidence of Coverage document for details.
What if Medicare denies my home health claim?
You can appeal. The denial notice will explain why coverage was denied and outline your appeal rights. You typically have 60 days from the date of the notice to request a redetermination. Contact your home health agency, your doctor, or a Medicare counselor for help with the appeal process.
Can Medicare cover home health after a hospital stay?
Yes. If you were hospitalized for at least three days (not counting the discharge day) and meet the other eligibility criteria, Part A may cover home health services as part of your recovery. After a qualifying hospital stay, you do not need to meet the homebound requirement for the first 14 days of home health care.
What is a Medicare Savings Program and can it help with home care costs?
A Medicare Savings Program (MSP) is a Medicaid-funded program that helps people with limited income pay Medicare premiums, deductibles, and cost-sharing. While home health visits themselves are $0 under Medicare, an MSP can help you afford the Part B premium so you maintain your Medicare coverage. Use our benefits screener to check whether you qualify.
