Key Takeaways
- Original Medicare Part A may cover home healthcare after hospitalization, while Part B may cover eligible home healthcare services when you haven’t been hospitalized.
- To qualify for Medicare-covered home healthcare, you must need intermittent or part-time support, have difficulty leaving home without assistance, and have a doctor certify your need for care.
- Typically, you will not pay anything for eligible home health services. However, you’ll pay a 20% coinsurance toward the cost of eligible medical equipment you may need as part of your home care, after you’ve paid the 2025 Part B deductible of $257.
Sometimes, you may need intermittent or temporary home healthcare, such as after a hospital stay when you still require a certain amount of care.
Medicare can cover various home healthcare services.
| Type of care | When it is covered |
|---|---|
| Skilled nursing care | • Your care needs require skilled nursing. • The services you need are reasonable and necessary for treating your injury or illness. • You receive the services intermittently or part-time, meaning fewer than 8 hours per day and 28 hours or fewer per week. |
| Physical therapy Occupational therapy Speech-language pathology | • These services are a safe, effective, and specific treatment for your condition. • They’re complex enough that you can only get them effectively and safely from a qualified therapist. • Your condition requires therapy to improve or restore functions affected by illness or injury, or your condition requires a skilled therapist or therapist assistant to effectively and safely perform therapy to prevent your condition from worsening or maintain your current condition. • Medicare deems the frequency, amount, and duration reasonable. |
| Home health aide | • Your illness or injury requires health aide services, such as personal care. • You require intermittent or part-time home health aide services. • You also receive skilled care, such as skilled nursing or physical therapy. |
| Medical social services | • Your doctor orders social services, such as counseling, or helps you find community resources to help with social and emotional concerns that may interfere with your recovery. • You also receive skilled care. |
| Medical supplies | Your doctor orders supplies, like wound dressings, as part of your care. |
Durable medical equipment (DME), such as hospital beds, walkers, or wheelchairs, isn’t billed as part of home healthcare services. It’s billed and covered under its own category within Medicare Part B.
Medicare Part A or Part B may cover your home healthcare services if you need intermittent or part-time care and can’t leave your home without assistance. Medicare refers to this difficulty leaving your home without assistance as “homebound.”
It defines “homebound” as:
- difficulty leaving your home without assistance due to illness or injury
- possession of a doctor’s recommendation to avoid leaving home because of your illness or injury
- challenges leaving home because it requires a major effort
To qualify for home healthcare services, your doctor or another healthcare professional must assess you face-to-face and certify that you require this type of care.
What isn’t covered
Medicare doesn’t cover:
- meal delivery services
- 24-hour-a-day care at home
- homemaker services, such as shopping and cleaning, unrelated to your plan
- custodial or personal care that helps with daily activities, such as bathing or dressing, when this is the only care you receive
Typically, you don’t need to pay anything for home health services. The home health agency should inform you how much Medicare can pay and whether the agency provides services or items Medicare doesn’t cover. The agency should also tell you how much these services may cost.
Once you meet the Part B deductible of $257, you’re responsible for 20% of the Medicare-approved costs for medical equipment.