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En español | Yes, but Medicare Parts A and B require you to meet specific criteria for home health care coverage, particularly if you’re mostly or entirely confined to your home. Medicare will cover part-time or intermittent skilled nursing care, therapy and other aid that’s determined to be medically necessary and ordered by your doctor.
But Medicare won’t pay for care to help you with activities of daily living, such as bathing, dressing, eating or going to the bathroom. If that’s the only care you need, you won’t receive coverage.
To be eligible for home health benefits, Medicare must approve the home health agency caring for you and you must meet the following criteria:
If you qualify for home health benefits, Medicare may cover the following services:
Medicare may extend that limit if your doctor can predict when your need for daily skilled nursing care will end. Full-time or long-term nursing care typically wouldn’t qualify for home health benefits.
If you qualify, you pay nothing for home health care services from a home health agency. Other medical services, such as visits to your doctor, are covered under your other Medicare benefits.
You may also have coverage for some supplies, such as catheters and wound dressings related to your condition when your home health agency provides them. This might include durable medical equipment from the home health agency, such as walkers or wheelchairs.
Medicare Part B covers equipment and supplies. But you’ll have to pay the Part B coinsurance, which is 20 percent of the Medicare-approved amount, after you pay your $233 Part B deductible for 2022 ($226 in 2023).
Additional services that you or a supplemental insurance will have to pay for include:
Medicare.gov has a search and comparison tool to help you find certified home health agencies in your area that Medicare covers.
If you have coverage from a private Medicare Advantage plan, rather than original Medicare, you may have to use an agency that works with that Advantage plan. Talk with a Medicare Advantage plan representative about coverage details and requirements.
Before you start receiving care, the agency should let you know, both verbally and in writing, of services provided that Medicare won’t cover and what you can expect to pay for them.
You may be able to get additional caregiving support through local and state programs, which may provide services such as adult day care programs, equipment, meal delivery, respite care for caregivers and transportation. You can find out more about programs in your area through your Area Agency on Aging. Type your zip code or city and state into the U.S. Administration on Aging’s Eldercare Locator or call 800-677-1116, to find contact information for your local agency and other resources.
Updated October 20, 2022
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