July 25, 2022
Question: I want to stay in my home as long as possible, but I need some help. Does Medicare cover home health care?
Answer: Medicare does cover in-home health care services under certain conditions. Keep in mind, Original Medicare may have different coverage than a Medicare Advantage Plan. Under Original Medicare, your doctor will have to certify that you need certain in-home care such as nursing care, physical therapy, medical social services, and certain medical supplies. Your doctor must also certify that you are homebound due to an illness or injury.
Medicare will only cover “intermittent” skilled nursing care - meaning you need care fewer than 7 days a week for less than 8 hours per day for up to 21 days. Coverage may be extended beyond the 21-day limit if your doctor requests it. It typically won’t cover full time care that is needed over an extended period of time. Medicare doesn’t cover 24-hour home care, meal delivery, or services such as shopping or cleaning.
If you have a Medicare Advantage Plan, you’ll need to contact your private insurance company to learn more about your coverage for in-home health care. Medicare Advantage may cover some additional services not covered under Original Medicare such as modifications to your home including a ramp for wheelchair access or a hold bar in the bathroom.
While Medicare & Medicare Advantage Plans do offer some limited benefits for in-home care, they are not a replacement for long term care planning. We work with clients to determine how advanced care costs may impact their financial health and make a plan that helps them feel in control as they age.
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