What Medicare Covers: Caregiver and Home Health Services Explained

Medicare reimburses short‑term home health services—such as skilled nursing, physical therapy, and occupational therapy—when you cannot leave home and a physician orders the care.

When a medical condition limits your ability to go out, receiving care at home can be more convenient, less costly, and just as effective as inpatient treatment.

Original Medicare (Part A and Part B) may cover medically necessary home care if you are homebound. For a limited period after an illness or injury, Medicare can also fund certain in‑home assistance. However, long‑term custodial care (help with daily living activities) is generally not covered.

Whether Medicare pays for an in‑home caregiver depends on the type of care, the underlying medical reason, and the duration of services.

If you are homebound because of illness or injury, you may qualify for Medicare home‑health benefits when all of the following apply:

• You can leave home only for brief outings (e.g., doctor’s appointments or religious services). Adult‑day‑care attendance is an exception.
• Your physician documents the need for home care and provides a written care plan.
• You require skilled nursing care (no more than 8 hours per day and 28 hours per week, for up to 3 weeks).
• Your doctor expects a reasonable, predictable improvement in your condition.
• You need a licensed physical, occupational, or speech therapist to design a program that maintains or improves your health.
• You require a home‑health aide to assist while you recover.
• The agency delivering care is Medicare‑certified.

To stay eligible, you must see your physician within 90 days before or 30 days after home‑health services begin.

Physical therapy

When a physical therapist provides care at home, Medicare typically covers:

• Initial assessment
• Gait training and therapeutic exercises after surgery, injury, illness, or stroke
• Post‑operative wound care
• Treatment of wounds, burns, or lesions

Occupational therapy

Home‑based occupational therapy may include:

• Establishing routines for medication, meals, and personal care
• Energy‑conservation and stress‑reduction strategies
• Safe‑task training for daily activities
• Functional skill restoration tailored to your condition
• Implementation of physician‑ordered interventions

Speech therapy

In‑home speech‑language services can provide:

• Word‑recall and recognition training
• Swallowing therapy
• Techniques to eat and drink safely
• Alternative communication methods when speech is impaired
• Communication strategies for hearing loss

Nursing care

Registered or licensed practical nurses visiting your home may:

• Change wound dressings
• Replace catheters
• Administer injections
• Provide tube feedings
• Deliver intravenous medications
• Teach self‑management of medications and care

Home health aides

Home health aides commonly assist with:

• Monitoring vital signs (heart rate, blood pressure, temperature)
• Ensuring medication adherence
• Assessing home safety relative to your condition
• Promoting adequate nutrition and hydration

Other services

Qualified beneficiaries may also receive in‑home social services, such as community‑resource referrals and emotional or psychological counseling.

A 2023 industry survey reported a median monthly cost of $6,292 for a home‑health aide.

Medicare parts that may cover home‑care services

• Part A: After a qualifying hospital stay of at least three consecutive days or a skilled‑nursing‑facility admission, Part A covers up to 100 days of home health care. Most enrollees pay $0 premium, but the 2025 deductible is $1,676.
• Part B: If you need home health services without a prior hospital admission, Part B covers them. The 2025 premium starts at $185 (income‑based) with a $257 deductible.
• Part C (Medicare Advantage): Plans must provide at least the same coverage as Original Medicare, though costs and network restrictions vary by plan and location.
• Part D: Prescription‑drug plans may help pay for medications needed during a home‑health episode; costs depend on the specific plan.
• Medigap: Supplemental policies can offset out‑of‑pocket expenses that Original Medicare does not cover; premiums vary by market.

If out‑of‑pocket costs become burdensome, a long‑term‑care insurance policy can help bridge the gap.

Medicare generally does not cover custodial care—services such as housekeeping, shopping, laundry, bathing, dressing, or toileting—unless the assistance is medically necessary for a short recovery period after an illness or injury and is certified by a physician.

Specific services Medicare does NOT pay for include:

• 24‑hour in‑home care
• Full‑time skilled nursing
• Transportation

Your home‑health rights under Medicare

Medicare guarantees the following rights:

• Choose your home‑health professionals
• Respect for your home and personal belongings
• Written copy of your care plan
• Control over your health‑care decisions
• Notification of any changes to your plan
• Privacy protection
• Ability to designate a family member or representative for decision‑making
• Written estimate of any costs you may owe
• Access to a hotline for reporting fraud or abuse
• Information on how to appeal decisions and report misconduct

To locate certified agencies, use Medicare’s home‑health agency finder and consult the agency checklist to verify the level of care offered.

State Survey Agencies maintain up‑to‑date quality reports; you can find your state’s directory on the Medicare website.

Medicare permits care from only one agency at a time. Switching agencies requires a new physician referral and notification to both the current and new agencies.

While Medicare does not fund purely custodial care, it does cover skilled services—physical, occupational, speech therapy, skilled nursing, and social services—when you are homebound after surgery, illness, or injury, provided a physician certifies medical necessity and the agency is Medicare‑certified.

Disclaimer: This information is for educational purposes only and does not constitute insurance advice. Healthline Media does not sell, broker, or endorse any insurance products.