Medicare Home Health Care

Medicare can cover eligible home health services when you meet Medicare’s requirements for skilled care and homebound status. Medicare does not generally cover ongoing custodial home care when personal assistance is the only care you need.

The key distinction is whether you need medically necessary skilled home health services under a Medicare-covered plan of care.

When does Medicare cover home health care?

Medicare Part A and/or Part B can cover eligible home health services when all applicable requirements are met.

In general, you must:

• be under the care of a doctor or other allowed provider;
• need part-time or intermittent skilled nursing care, physical therapy, speech-language pathology, or qualifying occupational therapy;
• be considered homebound under Medicare’s rules;
• receive services under a care plan established and reviewed by your provider; and
• receive the care from a Medicare-certified home health agency.

A doctor or other allowed provider must generally complete a face-to-face assessment and order the care.

What does homebound mean?

Being homebound does not mean you can never leave your home.

Medicare generally considers you homebound when leaving home is difficult because of illness or injury, you need help such as a device, special transportation, or another person, or leaving home is not recommended because of your condition—and you are normally unable to leave home or doing so requires a major effort.

Short or infrequent absences do not automatically disqualify you.

What home health services can Medicare cover?

When you qualify, covered home health services can include:

• part-time or intermittent skilled nursing;
• physical therapy;
• speech-language pathology;
• occupational therapy when Medicare’s requirements are met;
• medical social services;
• part-time or intermittent home health aide services when you are also receiving qualifying skilled care;
• certain medical supplies; and
• durable medical equipment ordered for use at home.

Examples of skilled nursing can include wound care, injections, monitoring an unstable health condition, and patient or caregiver education.

What does Medicare not cover as home health?

Medicare does not pay for:

• 24-hour-a-day care at home;
• home meal delivery;
• homemaker services such as shopping or cleaning when they are unrelated to your covered care plan; or
• custodial or personal care, such as bathing, dressing, or toileting, when that is the only care you need.

This is why "home health" and "home care" should not be treated as interchangeable terms.

Home health vs. home care

Home health is medically necessary skilled care delivered at home under Medicare coverage rules. It can include nursing, therapy, and certain related services.

Home care often means non-medical help with activities of daily living, companionship, meal preparation, housekeeping, or supervision.

A person can need both kinds of support, but Medicare coverage for skilled home health does not create general coverage for unlimited non-medical caregiving.

How much does Medicare-covered home health cost?

For covered home health services, Medicare states that you pay $0 for the approved home health services themselves.

For Medicare-covered durable medical equipment used at home, you generally pay 20% of the Medicare-approved amount after the Part B deductible.

If a service or item is not expected to be covered, the home health agency should explain your potential financial responsibility and may need to provide an Advance Beneficiary Notice before furnishing non-covered services or supplies.

How many hours of home health can Medicare cover?

Medicare home health is designed for part-time or intermittent skilled care.

In most cases, Medicare describes part-time or intermittent skilled nursing and home health aide services as up to 8 hours per day combined and up to 28 hours per week. In limited situations, more frequent care may be covered for a short period, up to 35 hours per week, when medically necessary.

If you need more than part-time or intermittent skilled care on an ongoing basis, you may not qualify for the Medicare home health benefit.

What if I have Medicare Advantage?

Medicare Advantage plans must cover Medicare-covered home health services, but plan rules can affect how you receive care.

Check your plan’s provider network, authorization requirements, and home health procedures before services begin.

Questions to ask before home health starts

Ask:

1. Is the agency Medicare-certified?
2. Has my provider documented that I meet the home health requirements?
3. What skilled service is being ordered?
4. How often will the service be provided?
5. Which services are Medicare-covered?
6. Will I owe anything for equipment or non-covered services?
7. If I have Medicare Advantage, is the agency in network and is authorization required?

Get help understanding Medicare coverage

Wise Owl Insurance Group can help explain how Medicare coverage and Medicare plan rules may apply to home health services. Coverage decisions depend on Medicare requirements, the services ordered, and your coverage.

Wise Owl Insurance Group is not connected with or endorsed by the U.S. government or the federal Medicare program. For official coverage rules, use Medicare.gov or call 1-800-MEDICARE.

Last reviewed: September 22, 2026.