Home Health Care: What Medicare Covers at Home

Say you are a retired bus mechanic in your late 70s, going home after a hip replacement. The hospital says a nurse and a physical therapist will visit you at home. You live alone and wonder who will be there the rest of the time, and what all of it will cost.

Medicare's home health benefit can bring skilled care into your home so you can recover where you live. It is also narrower than many people expect. This guide explains who qualifies, what Medicare pays for, paying privately for more, and how it differs from hospital at home.

What home health care is

Home health care is medical care in your home, ordered by a doctor or other provider. It is part-time or "intermittent," meaning visits, not someone there all day. It can include:

• Skilled nursing, such as wound care, shots, and IV (through a vein) or nutrition therapy.
• Therapy: physical, occupational, and speech-language therapy, if you meet certain conditions.
• Medical social services, medical supplies, and durable medical equipment, meaning equipment built to last, such as a walker.
• A home health aide, for help with bathing or dressing. This is covered only while you also get skilled nursing or therapy¹.

Non-medical help, such as cleaning or companionship, is a different thing. Our guide Help at Home: What It Is and Who Pays covers it.

Who qualifies

Under Original Medicare (Parts A and B), you generally qualify when all of these are true²:

• You are homebound. That means leaving home is not recommended because of your condition. Or you normally do not leave, because leaving takes a lot of effort. You can still leave for medical care, short and infrequent outings such as religious services, and adult day care.
• You need part-time or intermittent skilled care, such as nursing or therapy.
• A doctor or other provider has seen you in person and confirmed you need home health care. A care plan guides your visits.
• A Medicare-certified home health agency provides the care.

What it costs

For covered home health services, you pay $0. For Medicare-covered medical equipment, after you meet the Part B deductible (the amount you pay each year before Medicare starts to pay), you pay 20% of the Medicare-approved amount².

If you have a Medicare Advantage plan, the plan sets its own rules and costs, so check with it first. As of June 2026, about 90% of people in Medicare Advantage were in plans that require prior authorization for home health care. That means the plan must approve the care before it starts. Plans also often limit their network, the providers they work with³. Ask whether the agency is in network and whether approval is needed.

What you get, and what you do not

In most cases, "intermittent" means nursing and aide visits of up to eight hours a day combined. The total is no more than 28 hours a week. Your provider may approve more for a short time, up to 35 hours a week².

Medicare does not pay for:

• 24-hour-a-day care at home.
• Meals delivered to your home.
• Homemaker services, such as shopping and cleaning, that are not part of your care plan.
• Personal care, such as bathing or dressing, when that is the only care you need.

Those limits come straight from Medicare². For the hours in between visits, people usually rely on family, friends, hired help, or local programs.

Paying privately for care at home

Many families pay out of pocket for care Medicare does not cover. That might be more nursing hours, an overnight nurse after a hard surgery, or skilled care that continues after Medicare's coverage ends. Licensed home health and home care agencies sell this care directly, by the hour or by the visit.

As of March 2026, the national median cost of private duty nursing at home was $90 an hour, or $160 a visit. Non-medical help, such as bathing, meals, and errands, had a median of $35 an hour⁴. Prices vary widely by place, so ask several agencies.

Ways people pay for it:

• Savings and income. Many families pay this way, often for a set number of hours each week.
• Long-term care insurance. These policies are designed to pay for personal and custodial care, meaning help with daily tasks like bathing and dressing rather than medical care. That includes care in your home. Most pay a daily amount up to a limit you chose. Many stop after a set number of years⁵. Call the company to ask what it pays for at home and how to start a claim.
• VA Aid and Attendance. Veterans and survivors who get a VA pension and need help with daily tasks may get an added monthly payment⁶.
• Medicare Advantage extras. Some plans offer limited in-home support. Ask your plan what it covers this year.

Before you need it, ask an agency:

• What are your hourly and visit rates, in writing?
• Is there a minimum number of hours?
• Are your nurses and aides employees, and are they licensed and insured?
• How fast can you send someone?

One caregiver group suggests a test question: "If I called you at 2am needing someone by morning, what would that look like?"⁷.

Hospital-level care at home

Some hospitals now offer hospital-level care at home for certain illnesses, which is different from home health care. Our guide Hospital at Home: What Your Medicare Plan Covers and How to Get Your Home Ready explains how it works and how your Medicare plan treats it.

After a hospital stay

Hospitals must plan for your discharge, the day you go home. Federal rules say the plan must include you and your caregivers or support people as active partners. It must also look at whether you will need services such as home health care. If you are referred to home health, the hospital must give you a list of Medicare agencies that serve your area, and respect your choice⁸.

Speak up during that planning. Tell the team if you live alone, have stairs, or will need help with meals and errands. Ask who will order your equipment, and when the first visit will be.

Some procedures come with their own rule. Say you get anything more than local anesthesia (numbing just one spot). Then the anesthesia doctors' national society says you must leave with a responsible person, as Mayo Clinic researchers describe⁹. If you live alone, line up that person before the procedure date. Our guide Planning for the Hospital, a Move, or the End of Life covers the papers and plans to have ready.

Ways to fill the gaps

• Choose an agency with care. Medicare's Care Compare tool lets you find and compare home health agencies near you.
• Ask about other help at home. Your Area Agency on Aging may offer homemaker help, meals, and caregiver support. Call the Eldercare Locator at 1-800-677-1116 to find yours.
• Check Medicaid. If your income and savings are limited, your state's Medicaid program may cover more help at home. Rules vary by state.
• Look at your other housing costs. A recovery can strain the budget. See Help with housing costs, state by state for help with repairs, utility bills, and property taxes.

What can change it

Home health care is meant to end. As you recover and are no longer homebound or no longer need skilled care, Medicare coverage stops. Ask the agency how it will tell you, and what you can do if you disagree.

Changes at home matter too. Grab bars, a clear path to the bathroom, or a bed on the first floor can make the first weeks easier. Our guide Making Your Home Safer to Age in and to Share has ideas.

An extra set of hands

The first days home are often the hardest. A nurse may come for an hour, and then the house is quiet. Another person in the home, a family member, a friend, or a neighbor can make those days easier. But only if they want to, and it is agreed in advance.

• What it accomplishes: a ride home, picking up prescriptions, bringing in meals, and letting the nurse or therapist in.
• What it protects: someone nearby if you feel dizzy or need to call for help.
• What it preserves: your dignity and your family relationships. When an aide or another person in the home covers bathing help or the hours between visits, you stay in charge of your recovery. Your children get to visit as family, not as nurses.
• What it offers: company, and a familiar voice in the house.

Help is optional and agreed in advance. Being present is not caregiving. Changing dressings, managing medicines, and hands-on help with bathing belong to the home health team or a trained, paid worker. Household jobs like roofs, trees, electrical, plumbing, gas, and anything on a ladder above the first floor belong to licensed professionals. Our guide Help Around the House Is Not Caregiving explains where that line sits.

Watch for

• Calls or visits offering "free" home health care you did not ask for. Covered care starts with your own doctor's order.
• Signing for visits or equipment you never received. Read your Medicare or plan statements, and call 1-800-MEDICARE about anything you do not recognize.
• Assuming Medicare will cover the time between visits. Plan for those hours before you leave the hospital.

Conversation starters

If you are an adult child or friend talking with an older adult:

• "Can I sit in when the hospital talks about your discharge plan?"
• "Who would you like to have around the first few days home?"
• "Should we check whether the agency is covered by your plan?"

If you are an older adult talking with family or caregivers:

• "The nurse comes twice a week. I need to figure out the rest of the time."
• "I'd like someone to drive me home after the procedure. Could you?"
• "I want to recover at home, so let's plan it before I go in."

Medicare's home health benefit can bring skilled care into your home so you can recover where you live.

Last reviewed October 14, 2026