Medicare home health covers part-time or intermittent skilled care at home, such as nursing and therapy, for people who need it and are homebound. A doctor or other provider must order the care, and a Medicare-certified agency must provide it. Covered home health services cost nothing, but Medicare does not pay for around-the-clock care or help with daily tasks alone.
After a hospital stay, "home health" is one of the first phrases a family hears. It is also easy to confuse with private home care. This guide sticks to what Medicare says on its own coverage page, so you know what to ask for and what to expect.
What does Medicare home health cover?
Medicare lists these covered services when they are medically necessary (Medicare.gov, Home health services):
- Part-time or intermittent skilled nursing care, such as wound care, patient and caregiver education, injections, and monitoring of a serious illness or unstable health status
- Physical therapy, occupational therapy, and speech-language pathology services, if the person meets certain conditions
- Medical social services
- Part-time or intermittent home health aide care, such as help with walking, bathing, or grooming, but only when the person is also getting skilled nursing, physical therapy, speech-language pathology, or occupational therapy at the same time
- Durable medical equipment and medical supplies for use at home
For a parent coming home after surgery or a hospital stay, that usually means a nurse or therapist visiting on a schedule the agency and the provider set. It does not mean someone who lives in the home.
What does Medicare home health not cover?
The same page says Medicare does not pay for:
- 24-hour-a-day care at home
- Home meal delivery
- Homemaker services, such as shopping and cleaning, that are unrelated to the care plan
- Custodial or personal care, such as bathing, dressing, or using the bathroom, when that is the only care needed
This is the gap that surprises families most. If your parent needs daily help but no skilled care, Medicare home health will not fill it. Medicare's long-term care page explains that most long-term care is non-medical and that Medicare does not pay for it, though Medicaid may, depending on state rules, and some people buy private long-term care insurance (Medicare.gov, Long-term care). Our comparison of home health and home care after discharge covers the private side, and the post on the cost of aging in place puts numbers on the choices.
Who qualifies for Medicare home health?
Medicare sets these requirements (Medicare.gov):
- Skilled need. The person must need part-time or intermittent skilled services. Someone who needs more than part-time or intermittent skilled care does not qualify.
- Homebound status. Leaving home is not recommended because of the condition, or it is hard without help, such as a cane, wheelchair, walker, crutches, special transportation, or another person. The person is normally unable to leave home, and leaving takes a lot of effort.
- An in-person visit and an order. A doctor or other health care provider, such as a nurse practitioner, must see the person in person, confirm the need for home health care, and order it.
- The right agency. A Medicare-certified home health agency must provide the care.
"Homebound" is not the same as "never leaves the house." Medicare says a person may leave home for medical treatment or for short, infrequent absences for non-medical reasons, such as attending religious services. A person can still get home health care while attending adult day care.
What does Medicare home health cost?
Medicare says you pay nothing for covered home health services. After the Part B deductible, you pay 20 percent of the Medicare-approved amount for covered medical equipment. Before care starts, the agency should tell you how much Medicare will pay. It should also tell you, verbally and in writing, if Medicare will not pay for items or services it plans to give, and it should hand over a notice called the Advance Beneficiary Notice before providing them (Medicare.gov).
If your parent has a Medicare Advantage Plan or another Medicare health plan, check the plan for its home health rules. If equipment such as a bed is part of the plan, our guide to getting a hospital bed at home covers the equipment side.
How many hours or visits are covered?
If your parent qualifies, Medicare says there is no cap on the number of home health visits. In most cases, "part-time or intermittent" means skilled nursing and home health aide services up to 8 hours a day combined, for a maximum of 28 hours a week. A provider may order more frequent care for a short time, up to 35 hours a week, if they decide it is necessary (Medicare.gov).
How do you start home health after a hospital stay?
Start before discharge, while the hospital team is still involved.
- Ask the discharge planner or social worker whether your parent is likely to qualify, and who will place the order. The Medicare discharge checklist suggests asking where care will happen after discharge and whether home health is an option (Medicare.gov, Your discharge planning checklist).
- Ask for the list of agencies. Medicare says the provider should give a list of agencies that serve your area, and must tell you if their own organization has a financial interest in any agency listed.
- Expect a call from the agency. Once your parent is referred, the agency schedules an appointment to talk about needs and health, then works with the doctor on a care plan and keeps them updated.
- Ask for the schedule in writing. Home health staff should visit as often as the provider orders. Put each visit on the family calendar.
If the answer is "no" or "not yet," ask what else is available and who can help. The Eldercare Locator connects families to local services by phone at 1-800-677-1116.
What should the family coordinate once visits begin?
Medicare pays for the clinical visits. It does not manage the household around them. A few shared jobs make home health work better:
- Who is home for each visit, and who answers the agency's calls
- What the nurse or therapist asked the family to do, written down the same day
- Which questions go to the doctor, collected in one place before the next appointment
- Who handles equipment, supplies, and prescription pickup
Our first-week checklist for a parent coming home from the hospital and the questions to ask before discharge help turn those into assignments. If your parent lives alone, read living alone after hospital discharge too.
How VIPCall can help the family around the visits
VIPCall is not a home health agency and does not provide nursing, therapy, or hands-on care. It helps the family stay in touch between visits.
- Daily phone call. VIPCall calls your parent on any phone, with no app, and texts the family a short summary after each call.
- To-dos. Create to-dos for the tasks around each visit, such as being home for the nurse or picking up supplies, and assign each one to a family member.
- Appointments. Keep the agency visits and the doctor's follow-up on a shared schedule, and subscribe a family member's calendar app to see confirmed appointments.
- Documents. If you turn on the optional AI filing setting for documents, you can upload the care plan and get a short summary with the dates, phone numbers, and medicines picked out. Confirm every detail with the agency.
VIPCall supports family communication and follow-through. It does not assess medical safety, provide hands-on care, or respond to emergencies. See how VIPCall works and compare family plans and pricing.