What Medicare Home Health Covers (and What It Doesn't)

Reviewed by Ylmard Grimaldi, LVN
Last reviewed: October 2, 2026

Medicare may cover care at home, like visits from a nurse or a therapist. But it does not cover every kind of help at home. This guide explains what is often covered, what is not, and what it may cost.

The short answer

• Medicare may cover part-time care from a nurse or therapist in your home.
• You must meet Medicare's rules first.
• If you qualify, you pay $0 for covered home health services.
• Medicare does not pay for care around the clock, meals brought to your home, or chores.
• For equipment like a walker, you usually pay 20% of the Medicare-approved amount.

Who can get it

Medicare may cover home health care if all of these are true:

• You are under the care of a doctor or other allowed provider. This can be a nurse practitioner or a physician assistant.
• Your doctor or provider makes a care plan for you. They check it often.
• You need skilled care part of the time. This means care from a nurse, a physical therapist, or a speech therapist.
• You are "homebound." See below for what this means.
• A doctor or allowed provider must see you for a visit about the main reason you need care. This is called a "face-to-face" visit. It must be in the 90 days before home health starts, or in the 30 days after.
• The home health agency is Medicare-certified. This means it meets federal health and safety rules.

What "homebound" means

• It is very hard for you to leave home. Or your doctor says you should not leave home because of an illness or injury.
• You may need help to go out. This could be a cane, walker, wheelchair, special ride, or another person.
• You can still leave home to get medical care.
• You can still take short trips once in a while. A haircut, a walk around the block, or a family event is OK.
• You can still go to religious services or adult day care.

What "part-time" means

• Nurse and aide visits together are usually less than 8 hours a day.
• They also add up to 28 hours a week or less.
• For a short time, you may get up to 35 hours a week if your provider says you need it.
• If you need a nurse full-time, you may not qualify for home health.

What may be covered

If you qualify, Medicare may cover:

• Skilled nursing, part-time. A nurse may care for a wound, give shots or IV medicine, and check on a serious illness. The nurse also teaches you and your family.
• Physical therapy (PT). A therapist helps you walk and move more safely.
• Occupational therapy (OT). A therapist helps you do daily tasks, like bathing and dressing. OT usually starts along with nursing, PT, or speech therapy. It may go on by itself after those end.
• Speech therapy. A therapist helps with talking and understanding words.
• Medical social services. A social worker helps with worries that may slow your healing. They can also help you find help in your community. This is covered only if you also get skilled care.
• Home health aide care, part-time. An aide can help with bathing, dressing, and walking. This is covered only if you also get nursing or therapy.
• Medical supplies your doctor orders for your care, like wound dressings.
• Medical equipment, like a walker or wheelchair. Medicare covers this apart from home health. See the cost section below.

If you keep meeting the rules, there is no set limit on visits. Your doctor and home health team review your care plan at least every 60 days.

What is not covered

Medicare does not pay for:

• Care 24 hours a day at home.
• Meals brought to your home.
• Help with shopping, cleaning, or laundry.
• Personal care, like help with bathing, dressing, or using the bathroom, when that is the only help you need.
• A nurse visit that is only to draw blood.

Home health is not the same as home care (sometimes called private duty care). Home care helps with daily tasks like chores, meals, and bathing, and you often pay for it yourself.

What it may cost

• If you qualify, you pay $0 for covered home health services.
• Medical equipment means things like a walker, wheelchair, or oxygen equipment. For these, you usually pay 20% of the Medicare-approved amount. This is after you meet your Part B deductible.
• Before care starts, the agency should tell you how much of the bill Medicare is expected to cover. It should also tell you what Medicare may not cover and what you would owe. It should tell you this out loud and in writing.
• If Medicare may not cover a service or supply, the agency must give you a written notice first. It is called an "Advance Beneficiary Notice," or ABN.
• If you have other insurance, like a Medigap plan, tell your doctor or other provider. This helps your bills get paid the right way.

If you have a Medicare Advantage plan

• A Medicare Advantage plan (Part C) is run by a private company that works with Medicare.
• Your plan has its own details for home health. It may ask you to use agencies in its network. These are agencies the plan has a contract with.
• Read your plan's member papers, or call the plan. Ask what it covers and which agencies you can use.

You can choose your agency

If you need home health, you have the right to choose a Medicare-certified agency that serves your area, and your doctor, hospital, or discharge planner should respect your choice (CMS).

How to get started

• Talk with your doctor. Ask, "Is home health right for me (or my loved one)?" Home health needs an order from a doctor or allowed provider.
• If your doctor says you need home health, they should give you a list of agencies that serve your area.
• In the hospital? Ask the discharge planner about home health before you go home.
• Next, the agency's staff will talk with you about your needs. They will also talk with your doctor about your care plan.
• To learn about home health services, see our home health services page.
• To ask for care, see Request Care.

Questions to ask

Ask the doctor

• Do I (or does my loved one) meet the rules for home health?
• What care will be in the care plan?
• How often will the nurse or therapist come?

Ask the home health agency

• Are you Medicare-certified?
• Do you serve our area?
• Can you start when we need you?
• Is staff on call at night and on weekends?
• Will any of this cost us money? Can you tell us in writing?

Ask your Medicare Advantage plan (if you have one)

• Is this agency in your network?
• What home health care do you cover?

Where to get free help with Medicare questions

• Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
• Visit Medicare.gov.
• Call your State Health Insurance Assistance Program (SHIP). SHIP counselors answer questions about Medicare home health. Find yours at shiphelp.org or by calling 1-800-MEDICARE.

Related pages

• Our Services
• Request Care

Sources

1. Medicare.gov (CMS). "Home health services." https://www.medicare.gov/coverage/home-health-services (checked Oct 2, 2026, PT)
2. Medicare.gov (CMS). "Medicare & Home Health Care," CMS Product No. 10969, July 2025. https://www.medicare.gov/publications/10969-medicare-and-home-health-care.pdf (checked Oct 2, 2026, PT)
3. CMS. "Medicare Benefit Policy Manual, Chapter 7 – Home Health Services" (sections 30.5.1 face-to-face timing; 50.7 part-time or intermittent limits; 10.10 D freedom of choice). https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/bp102c07.pdf (checked Oct 2, 2026, PT)
4. CMS regulation, 42 CFR 409.42, "Beneficiary qualifications for coverage of services" (eCFR). https://www.ecfr.gov/current/title-42/section-409.42 (checked Oct 2, 2026, PT)
5. CMS regulation, 42 CFR 409.45, "Dependent services requirements" (home health aide and medical social services) (eCFR). https://www.ecfr.gov/current/title-42/section-409.45 (checked Oct 2, 2026, PT)
6. CMS regulation, 42 CFR 482.43(d), hospital discharge planning: list of home health agencies and the patient's "freedom to choose" (eCFR). https://www.ecfr.gov/current/title-42/section-482.43 (checked Oct 2, 2026, PT)
7. MedlinePlus, National Library of Medicine (NIH). "Home Care Services." https://medlineplus.gov/homecareservices.html (checked Oct 2, 2026, PT)

Last reviewed: October 2, 2026