Medicare’s Home Health Care Benefit – What You Should Know
By JCA on February 25, 2025
from the National Council on Aging
If you’re wondering “Is home health care covered under Medicare Part A or B?”, the answer is yes—it’s covered under both. Under Medicare Part B, you qualify for home health care if you’re homebound and require skilled care—even if you haven’t been previously hospitalized. In certain cases, such as after a hospital stay or time spent in a skilled nursing facility, you can receive home health care coverage under Medicare Part A.
What exactly is home health care? This type of care is meant to provide health services and equipment to individuals while they are recovering at home. Home health care includes a wide range of health and social services delivered in the home to treat illness or injury. What home health is covered by Medicare? Services covered by Medicare’s home health benefit include intermittent skilled nursing care, skilled therapy services, and care provided by a home health aide.
What are Medicare’s criteria for providing in-home nursing care?
1. To qualify for home health care, you must meet the following criteria:
- Be considered homebound based on the Centers for Medicare & Medicaid (CMS) criteria,
- Require skilled care on a part-time or intermittent basis to improve, maintain, prevent, or further slow your health condition,
- Be under the care of a nurse practitioner, clinical nurse specialist, physician’s assistant, or doctor, who completes and documents an in-person visit with you either:
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- three months before the start of home health care, or
- within one month after the home health care benefit has begun.
- Receive home health care from a Medicare-approved home health agency.
2. Medicare only covers care for specific services.
3. If you are enrolled in Original Medicare, you pay nothing for home health care services.
4. Custodial care (long-term care) is non-skilled personal care.
5. Medicare does not cover custodial care or nursing home care.
6. Some states offer custodial care programs for older adults.
7. It’s important to know the difference between home health care and home care.