As seniors in Encino and throughout California look for ways to stay healthy and independent at home, many families wonder: Does Medicare pay for home caregivers? This guide explains everything you need to know—what Medicare covers, eligibility requirements, the types of in-home help available, how Medicare differs from Medicaid, and the best steps for getting care in Encino.
What Is “Home Care” and Who Needs It?
Home care generally refers to a range of services that help seniors continue living safely at home. This can include help with bathing, dressing, meal preparation, mobility, medication reminders, and even medical care after an illness or surgery. In Encino, many older adults prefer home care because it offers comfort, familiarity, and greater independence compared to moving into a facility.
- Personal care: Bathing, grooming, and dressing
- Household tasks: Cooking, cleaning, laundry
- Medical care: Wound care, injections, physical therapy
- Companionship: Friendly visits, social engagement
What Home Care Services Does Medicare Cover?
Medicare—America’s federal health insurance for people age 65+ and certain younger people with disabilities—offers limited coverage for in-home care. It’s important to understand that Medicare primarily covers “home health care,” which is medically necessary care, rather than non-medical “custodial” help like cooking or bathing. Here’s a breakdown:
Medicare Covers:
- Skilled nursing care (e.g., wound care, injections, medication management)
- Physical, occupational, or speech therapy (when ordered by a doctor)
- Medical social services
- Part-time home health aide services—but only if the recipient is also receiving skilled care
- Medical supplies for use at home (like wound dressings)
Medicare Does Not Cover:
- 24-hour home care or long-term care at home
- Meal delivery, housekeeping, or laundry
- Personal care (help with bathing, dressing, using the toilet) unless provided alongside skilled medical care
- Companionship
- Home care when only “custodial” help is needed
For those seeking help with personal needs like bathing or dressing—known as “custodial care”—Medicare generally does not pay unless the care is part of a skilled medical plan of care. If you only need help with daily living activities, you may want to explore options such as home health aides or personal care services.
Who Is Eligible for Medicare Home Health Care?
To qualify for Medicare-covered home health care, you must meet all of these conditions:
- You must be under the care of a doctor, who creates and regularly reviews your plan of care.
- Your doctor must certify that you are homebound (leaving home requires considerable effort and is medically inadvisable).
- You need skilled care on an intermittent basis, such as nursing care, physical therapy, speech-language therapy, or ongoing occupational therapy.
- The home health agency providing care must be Medicare-certified.
If you qualify, Medicare will cover the full cost of medically necessary home health services (no copay for services, but you may pay 20% for certain medical equipment).
Understanding Home Health Aides and Personal Care Services
Medicare may pay for a home health aide only if you’re also receiving skilled nursing or therapy services as part of a doctor-approved care plan. The aide can help with basic personal care tasks—like bathing or dressing—but only for a limited time and only when skilled care is being provided.
If you need ongoing, non-medical help at home (like daily bathing, dressing, meal prep, or companionship), Medicare will not cover these personal care services on their own. For long-term support, you may need to consider other options, such as In-Home Supportive Services (IHSS) in California, private-pay caregivers, or Medicaid (Medi-Cal).
What About Medicaid or “IHSS” in California?
While Medicare’s coverage for home caregivers is limited, Medicaid (called Medi-Cal in California) offers much broader support. Seniors in Encino with limited income and assets may qualify for IHSS—California’s unique Medicaid-funded program that pays for non-medical help at home, including:
- Bathing, dressing, grooming
- Meal preparation and feeding assistance
- Light housekeeping, laundry
- Transportation to medical appointments
- Accompaniment and supervision
Unlike Medicare, IHSS pays caregivers—including, in some cases, family members—directly for providing these vital daily living supports. Medi-Cal eligibility is based on income, assets, and medical need. For more information, read our IHSS guide for Encino seniors.
Key Differences: Medicare vs. Medicaid (Medi-Cal) for Home Care
| Medicare | Medicaid / IHSS (California) |
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How to Apply for Medicare-Covered Home Health Care in Encino, CA
If you think you or a loved one in Encino may qualify for Medicare home health care:
- Ask your doctor if home health care is appropriate. Your doctor must order the services and set up your care plan.
- Choose a Medicare-certified home health agency. You can find local agencies via our Home Health Care directory or search Medicare’s Care Compare tool.
- The agency will assess your needs and work with your doctor to coordinate care. They’ll explain what Medicare covers and what it doesn’t.
- If you need services Medicare doesn’t cover, ask about private pay options, local senior programs, or applying for IHSS through Medi-Cal.
Tip for Encino residents: Many local agencies are familiar with both Medicare and IHSS processes. It’s smart to ask about all funding options—sometimes seniors qualify for both Medicare and Medi-Cal programs.
Local Encino, CA Resources for Seniors Needing Home Care
- All Seniors Foundation: Provides free guidance, referrals, and support to seniors and families exploring home care, IHSS, and Medicare services in Encino and nearby San Fernando Valley neighborhoods. Learn more about our services.
- IHSS Office – Los Angeles County: Apply or get help with the In-Home Supportive Services process: LA County IHSS
- Medicare Counseling: Free one-on-one counseling for seniors through HICAP (Health Insurance Counseling & Advocacy Program). Call 1-800-434-0222.
- Local Home Health Agencies: For medical care at home under Medicare, see our Encino directory.
- Home Health Aides and Personal Care: If you need daily living help, learn about Home Health Aides and Personal Care Services available in Encino.
Frequently Asked Questions (FAQs)
Does Medicare cover 24-hour home care?
No, Medicare does not cover 24-hour home care or round-the-clock caregivers. Coverage is for part-time skilled care only.
Can I get Medicare to pay for help with bathing or dressing?
Only if you’re also receiving skilled nursing or therapy care at home as part of a Medicare-approved plan. Otherwise, Medicare will not cover personal care or custodial care alone. For ongoing help, consider personal care services or IHSS.
Can family members be paid caregivers under Medicare?
No. Medicare does not pay family members to provide home care. However, IHSS (via Medi-Cal) may allow family to be paid caregivers in California.
What’s the difference between a home health aide and a personal care aide?
A home health aide under Medicare provides limited personal care, but only as part of a skilled care plan. A personal care aide helps with daily living tasks but is usually paid privately or through Medicaid/IHSS—not Medicare.
Where can I get help applying for home care services in Encino?
Contact the All Seniors Foundation for free guidance, or reach out to the Los Angeles County IHSS office for help with Medi-Cal applications. Your doctor and local home health agencies can also assist with Medicare services.
Key Takeaways for Encino Seniors and Families
- Medicare covers skilled medical home health care for those who qualify—usually after illness, injury, or hospitalization—but does not pay for long-term personal or custodial care at home.
- To get help with everyday activities (like bathing or meal prep), look into IHSS via Medi-Cal or consider private-pay caregivers and personal care services.
- Local resources in Encino—including All Seniors Foundation—can guide you through your options and help you apply for the support you need.
- Always check that any agency is Medicare-certified and that your doctor’s plan of care is in place before starting home health services.
Need More Help? Contact Us Today
If you or a loved one in Encino is considering home care, don’t navigate the process alone. Contact All Seniors Foundation for free, no-obligation help finding the right resources—whether it’s Medicare home health, IHSS, or private in-home support. We’re here to help you stay safe, healthy, and independent at home.
