Understanding Medicare and Home Care
Medicare can cover certain home health services when specific medical requirements are met, but it generally does not pay for ongoing non-medical personal care when that is the only care a person needs. We help you understand the distinction and explore other options that may be available.
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At a glance
- Funding source
- Federal Medicare
- Best for
- Seniors 65+ needing skilled home health care
- Covers
- Intermittent skilled care when requirements are met
Understanding Medicare
Medicare is the federal health insurance program for people 65 and older, some younger people with disabilities, and people with end-stage renal disease. When it comes to home care, it is important to understand what Medicare covers and what it does not.
Medicare can cover certain home health services when specific medical requirements are met, but it generally does not pay for ongoing non-medical personal care when that is the only care a person needs. We help families understand the difference and explore complementary options.
What may and may not be covered
Medicare home health benefits have specific requirements. Here is a plain-English summary.
Medicare may cover
- Intermittent skilled nursing
- Qualifying therapy (physical, occupational, speech)
- Medical social services
- Qualifying part-time home health aide care when Medicare requirements are met
Medicare usually does not cover
- x24-hour home care
- xStand-alone custodial or personal care
- xGeneral homemaker services unrelated to a qualifying care plan
- xMeal delivery
When Medicare may help with home care
Medicare home health benefits require a doctor’s order, a face-to-face visit, and care from a Medicare-certified home health agency. The care must be intermittent or part-time, and the patient must be considered homebound. These requirements are set by CMS.
- A doctor has ordered home health care as part of a plan of care
- You are enrolled in Medicare (Part A and/or Part B)
- You need skilled care such as nursing or therapy services
- You are considered homebound, meaning leaving home requires considerable effort
- Care is provided by a Medicare-certified home health agency
What support may be available
Complementary personal care
We provide non-medical personal care that works alongside Medicare-covered home health services.
Homemaker support
Meals, light housekeeping, and household tasks that Medicare does not generally cover.
Companionship
Social connection and supervision that supports well-being at home.
How it works
Talk with Healthy at Home
We help you understand what Medicare covers and what it does not.
Review your Medicare coverage
We discuss your situation and whether Medicare home health benefits may apply.
Coordinate with your home health agency
If you receive Medicare home health, we coordinate so care is complementary.
Build a complementary care plan
We design a plan for the personal care and support Medicare does not cover.
Begin care
We match your loved one with a caregiver and begin services.
How Healthy at Home helps
We provide the non-medical personal care and companionship that Medicare generally does not cover, working alongside Medicare-certified home health agencies so your loved one receives complete support.
- Explain what Medicare covers and does not cover in plain language
- Coordinate with your Medicare-certified home health agency
- Provide personal care, meals, and companionship that complement skilled care
- Adjust hours and services as your loved one’s needs change
- Help you explore other funding options if Medicare does not apply
Frequently asked questions
Related programs
Official resources
We encourage you to verify eligibility and coverage details with the official sources below.
Please note: Medicare coverage requirements are set by CMS. Healthy at Home does not determine Medicare eligibility. This information is for general education and is not a guarantee of coverage.
Have questions about medicare?
Tell us about your situation and our team will help you understand your options and next steps. There is no cost or obligation.