Reviewed July 26, 2026. Home health care is skilled healthcare delivered in a person’s home for an illness or injury. Medicare may cover medically necessary, part-time or intermittent services for eligible people who are homebound and under an ordered plan of care. Home health is not the same as 24-hour home care or non-medical custodial support.
Quick answer: Medicare-covered home health can include skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social services, certain supplies, and limited home health aide care when qualifying skilled care is also being received. A clinician must assess and order the care, and a Medicare-certified home health agency must provide it.
What home health care may include
- Part-time or intermittent skilled nursing, including wound care, injections, education, and monitoring of an unstable condition
- Physical therapy, occupational therapy, and speech-language pathology when coverage requirements are met
- Medical social services related to the care plan
- Part-time or intermittent home health aide support when the person is also receiving qualifying skilled services
- Certain medical supplies and durable medical equipment
Medicare eligibility basics
Medicare states that the person must need part-time or intermittent skilled services and be homebound. Homebound generally means leaving home is not recommended because of the condition or requires help, and the person is normally unable to leave without considerable effort. A healthcare provider must assess the person face to face, order the care, and establish the plan. The agency must be Medicare-certified.
Being homebound does not mean a person can never leave home. Medicare allows certain medical trips and short, infrequent absences. The certifying provider and agency apply the current requirements to the individual situation.
What Original Medicare generally does not cover
- 24-hour-a-day care at home
- Home-delivered meals as a home health benefit
- Homemaker services unrelated to the care plan
- Custodial or personal care, such as bathing or dressing, when that is the only care needed
Medicaid, Medicare Advantage supplemental benefits, long-term care insurance, veterans’ programs, county services, or private payment may offer different support. Verify each program separately.
Home health versus personal home care
Home health is clinical care tied to medical need and professional requirements. Personal home care supports daily activities and may not require a nurse or therapist. The names can sound similar, so ask the agency whether it is a Medicare-certified home health agency, a non-medical home care organization, or both.
Who may be part of the home health team
- Nurse: May provide wound care, injections, medication education, assessment, or monitoring ordered in the plan.
- Physical therapist: May address strength, balance, walking, transfers, and mobility equipment.
- Occupational therapist: May work on daily activities, upper-extremity function, cognition-related strategies, and home safety.
- Speech-language pathologist: May address communication, cognition, or swallowing when medically appropriate.
- Medical social worker: May help with social or emotional barriers connected to the medical condition and care plan.
- Home health aide: May provide limited personal care when the person is also receiving qualifying skilled services.
After a hospital discharge
- Ask the hospital team whether home health is medically indicated and whether an order has been placed.
- Get the medication list, wound or therapy instructions, follow-up appointments, equipment orders, and emergency warning signs in writing.
- Confirm the agency’s first visit date and who to call if it is delayed.
- Make sure the primary clinician and specialists know who is providing home health.
- Call the agency promptly if the person’s condition or home support changes.
How to choose a home health agency
- Confirm Medicare certification and applicable California licensing.
- Ask whether the agency serves the ZIP code and accepts the exact coverage.
- Ask how quickly care can start and how missed visits are handled.
- Confirm language access, after-hours support, and caregiver education.
- Request a clear explanation of what Medicare is expected to pay and any possible patient cost.
- Ask how the agency coordinates with the ordering clinician and reports changes.
Care-plan communication for families
Keep one current list of the ordering clinician, agency contacts, medications, allergies, equipment, visit schedule, and warning signs. Write down questions between visits. If a worker misses a visit or a symptom changes, contact the agency rather than assuming another team member was notified.
Families should understand which tasks are included and which are not. A home health visit is not a substitute for continuous supervision. If the person cannot remain safely alone, ask the care team about additional support options.
Fraud and enrollment red flags
Be cautious when an unknown company offers “free” home health, equipment, or genetic testing in exchange for a Medicare number. A legitimate home health episode should connect to an identified clinician, an assessed medical need, an ordered care plan, and a certified agency. Verify unexpected contacts using the plan or clinician’s known number.
Costs and coverage
Medicare says eligible beneficiaries pay nothing for covered home health services. For Medicare-covered durable medical equipment, the person generally pays 20% of the Medicare-approved amount after the Part B deductible. Medicare Advantage plans may use networks and plan-specific rules. Before care begins, the agency should explain expected coverage and provide required notices for items or services it believes Medicare will not cover.
Los Angeles home health navigation
All Seniors Foundation helps older adults, families, caregivers, and case managers in Los Angeles County understand senior-support and care-navigation options. We do not certify homebound status, order care, guarantee coverage, select a provider on a family’s behalf, or promise an outcome. Call (818) 581-4101, contact us, or browse our senior support services. Learn more about remote patient monitoring and physical therapy for older adults.
Frequently asked questions
Does Medicare pay for a caregiver all day?
No. Original Medicare does not cover 24-hour home care. Limited home health aide care may be covered only when qualifying skilled services are also being received.
Can someone leave home and still qualify?
Possibly. Short, infrequent absences and trips for medical treatment may be allowed. The certifying provider and agency evaluate the current homebound requirements.
Is home health only for recovery after surgery?
No. It may also be used to maintain function, slow decline, manage an illness, or provide medically necessary skilled care when requirements are met.
What if the person needs only bathing and dressing help?
Original Medicare generally does not cover personal or custodial care when it is the only need. Ask about Medicaid, county programs, plan benefits, long-term care insurance, or private home care.
Official sources
- Medicare: Home Health Services Coverage
- Medicare: Durable Medical Equipment Coverage
- CMS: Remote Patient Monitoring
This page is educational and is not medical, insurance, or legal advice. For an emergency, call 911.
