Does Medicare pay for home care (in-home caregivers)?

Updated October 6, 2026 · General information, not professional advice

Does Medicare pay for home care? Two kinds of help

Families often use "home care" to mean two different things, and Medicare treats them very differently:

• Home health care is medical: skilled nursing, physical therapy, occupational therapy or speech therapy at home. Medicare covers it when your parent qualifies.
• Home care (custodial or personal care) is non-medical: help with bathing, dressing, toileting, meals, housework, errands and companionship. Medicare does not pay for this when it is the only help needed.

Who qualifies for Medicare home health care

Under Original Medicare, your parent generally must:

• Be homebound, meaning leaving home takes a major effort or help from another person or a device, because of illness or injury.
• Need part-time or intermittent skilled nursing or therapy.
• Be under a plan of care set up by a doctor or other allowed provider, after a face-to-face visit related to the reason for care.
• Get care from a Medicare-certified home health agency.

Covered home health services cost $0. Your parent pays 20% of the approved amount for durable medical equipment like a walker, after the Part B deductible ($283 in 2026).

What Medicare covers at home and what it doesn't

Covered when your parent qualifies:

• Part-time skilled nursing (wound care, injections, monitoring a new condition).
• Physical, occupational and speech therapy.
• A home health aide for bathing and dressing, but only while your parent is also getting skilled care.
• Medical social services and medical supplies.

Not covered:

• 24-hour care at home.
• Meals delivered to the home.
• Homemaker services like shopping, cleaning and laundry not tied to the care plan.
• Personal care when that is the only care needed.

Combined nursing and aide visits are generally limited to fewer than 8 hours a day and 28 or fewer hours a week, though more may be allowed for short periods.

Who pays for in-home caregivers instead

• Private pay: most families pay an agency or hire a caregiver directly. The national median for a non-medical caregiver was about $35 an hour in 2025, and rates vary by state.
• Medicaid: every state offers some home and community-based services, often including personal care aides. Many states let the person choose their caregiver, sometimes a family member.
• VA: veterans may qualify for homemaker and home health aide services through VA health care, or for a pension with Aid and Attendance.
• PACE: in areas where it's offered, the Program of All-Inclusive Care for the Elderly covers home care for people 55 and older who need a nursing home level of care.
• Long-term care insurance: many policies pay for in-home care.
• Area Agency on Aging: local programs may offer limited homemaker help, meals and respite.

Home care with a Medicare Advantage plan

Medicare Advantage plans must cover the same home health benefits as Original Medicare, but they usually require you to use agencies in the plan's network and may require prior authorization before visits start. Some plans also offer extra in-home support benefits, such as a limited number of hours of help with chores or personal care, or meal delivery after a hospital stay. These benefits vary a lot from plan to plan and year to year.

To find out what your parent's plan covers, call the member services number on the card and ask:

• Which home health agencies are in network near us?
• Does home health need prior approval, and who requests it?
• Does the plan offer any in-home support or caregiver benefits this year, and how do we use them?

Write down the name of the person you spoke with and the date of the call.

How to get home health care started

1. Ask your parent's doctor whether they qualify for home health and request an order.
2. Choose a Medicare-certified agency; you can compare agencies on Medicare's Care Compare tool.
3. If they have a Medicare Advantage plan, confirm the agency is in-network and whether prior approval is needed.
4. For non-medical help, call your local Area Agency on Aging or state Medicaid office to ask about programs.

seniorcare.si can show licensed home care and home health agencies near your ZIP code.