What Medicare may cover
Medicare states that eligible beneficiaries may receive certain home health services, including medically necessary part-time or intermittent skilled nursing, qualifying therapy, medical social services, and limited home health aide care when the required conditions are met.
Coverage depends on clinical eligibility, an approved plan of care, and a Medicare-certified home health agency. Medicare Advantage plans may have different processes or additional benefits, so check the current plan directly.
What Original Medicare generally does not cover
Medicare lists 24-hour-a-day care at home, home meal delivery, homemaker services unrelated to the care plan, and custodial or personal care when that is the only care needed among services it does not cover under the home health benefit.
This distinction explains why a person can qualify for occasional skilled home health visits and still need to pay separately for meal help, supervision, transportation, or longer personal-care coverage.
Questions to ask before relying on coverage
Ask the clinician what skilled need supports the referral, which agency will provide services, how often visits are expected, what the plan covers, and which daily needs remain outside it. Ask the health plan to explain authorization, network, and cost-sharing requirements in writing when possible.
- Is the person eligible for the Medicare home health benefit?
- Which services and visit frequency are in the plan?
- Is home health aide care included and under what conditions?
- Which personal, household, or supervision needs remain uncovered?
- Does a Medicare Advantage plan offer any relevant supplemental benefit?
Build a plan for the uncovered hours
Combine confirmed benefits with family help, community programs, private-pay home care, long-term care insurance, veterans resources, or other eligible support. Avoid designing the schedule around benefits that have not been authorized.
Coverage rules and individual plans change. Use this article as a question guide, not a coverage determination or financial recommendation.
Primary sources
Use these official resources to verify current rules and coverage for an individual situation.
Important: This guide is general information and is not medical, legal, tax, insurance, or financial advice. Individual needs and rules vary. Contact the appropriate qualified professional for advice about a specific person or situation.