Many healthcare treatments once used to offer only in a hospital or a doctor’s office can now be done at your home. Home health care is usually cheaper, more convenient, and can be just as effective as what you’d find in a skilled hospital or nursing facility. In general, the purpose of home health care is to provide treatment for illness or injury.

Where possible, home health care helps you recover fast and at your convenience. Medicare pays for health services in your home if you meet specific eligibility criteria and if the services are considered appropriate and necessary to treat your illness or injury. This article describes the home health care services covered by Medicare.

If you’ve Medicare, you can use your home health care benefits. If:

You will not be eligible for home health care if you can leave home for a short time, for medical treatment, or frequent non-medical reasons. Non-medical reasons include a visit to the barbershop, a walk around the block or drive, or attending a family reunion, funeral, graduation, or other rare or unique events. However, you will get home health care if you attend adult daycare.

You don’t qualify for home health care services if you need more than intermittent skilled nursing care. To identify your eligibility for home health care, consider Medicare’s definition of intermittent nursing care. 

If you are expected to have full-time skilled nursing care for an extended period, you will not usually be eligible for home health benefits.

The elements of Original Medicare — Part A (hospital insurance) and Part B (doctor visits and outpatient treatment) — may cover home care. Services include:

Medicare does not cover:

Medicare pays your Medicare-certified home health agency a single payment for the services you receive during the 30-day care. You can take advantage of more than one 30-day period of care. Payment for each 30 days-care is based on your condition and care needs. Getting treatment from a Medicare-certified home health agency can cut your expenses. A Medicare-certified home health agency agrees:

Medicare home health benefits only pay for services offered by the home health agency. Other medical services, such as doctor visits or the need for equipment, are generally still covered by your other Medicare benefits.

The Medicare website has a search and comparison tool that help you find certified home health agencies in your area. If you have Original Medicare (Part A & B), choosing any approved agency will work.

Before you start receiving care, the agency must tell you, both verbally and in writing, whether some of the services they provide are covered by Medicare and what you will pay for them.

You can consult our licensed insurance agents specializing in Medicare to find the Medicare plan that matches your needs.