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The Medicare home health benefit serves millions of Americans and plays a key role in our health care system. The benefit allows many homebound older adults to get the skilled care they need while remaining in their homes.

This Spotlight describes Medicare rules for coverage of home health care services, which are complicated and often misunderstood. Recent changes to Medicare criteria for coverage of rehabilitation therapy and skilled nursing care have expanded the availability of home health services to people with chronic debilitating conditions. At the same time, reductions in Medicare payments may be limiting access to such services, and proposals to impose a copayment for services could further discourage their use.