Does Medicare Cover Home Health Care?

Yes, Medicare covers home health care, but only under very specific conditions. If you need part-time or intermittent skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy, Medicare Part A and/or Part B will cover eligible home health services. However, you must be homebound, and a doctor must certify that you need these services.

The reality is that Medicare does not cover 24-hour-a-day care at home, meals delivered to your home, or homemaker services like shopping, cleaning, and laundry. It also won't pay for custodial care - help with bathing, dressing, and using the bathroom - if that is the only care you need. Straight answers, no surprises: if you only need help with daily living activities, Medicare won't foot the bill.

You've worked hard to build your life, and you deserve to know exactly what your coverage does and doesn't do. The paper promises of the healthcare system often leave out the fine print. We believe in putting you on your side of the table so you can make the right decisions for your health and your wallet. Self-reliance isn't a slogan; it's about knowing the rules of the game so you don't get caught off guard.

To qualify for Medicare home health care coverage, you must meet all of the following conditions:

• You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.
• A doctor must certify that you need one or more of the following: intermittent skilled nursing care, physical therapy, speech-language pathology services, or continued occupational therapy.
• The home health agency caring for you must be Medicare-certified.
• A doctor must certify that you are homebound.

Being homebound means you have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or help from another person) because of an illness or injury, or leaving your home isn't recommended because of your condition. You can still be considered homebound if you leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services.

If you meet these conditions, Medicare pays for your covered home health services in full. Before your care starts, the home health agency should tell you how much Medicare will pay. They should also tell you if any items or services they give you aren't covered by Medicare, and how much you'll have to pay for them.

When it comes to Medicare, the real choice is Traditional Medicare (A+B) vs Medicare Advantage. The supplement decision comes AFTER you choose Traditional Medicare - it's a component of the Traditional path, not an alternative to Advantage. Understand the two paths first, then decide; if Traditional, a supplement fills the gaps by law. We'll walk you through every option so you can compare free, no obligation.