Does Medicare or Insurance Pay for Home Care?
Paying for home care is a major concern for many families. The good news is that insurance and government programs can help with some costs—if you know what to look for and how to qualify. Here’s a breakdown of what’s typically covered, and where to find additional help.
Medicare Coverage
- Medicare covers medical home health services prescribed by a doctor—such as nursing, physical therapy, or speech therapy—when the patient is homebound and needs skilled care.
- Medicare does not pay for non-medical care (like housekeeping, meal prep, or 24-hour supervision).
- To qualify, care must be provided by a Medicare-certified agency and ordered by your doctor.
Medicaid and State Programs
- Medicaid may cover non-medical home care for low-income seniors, especially through Home and Community-Based Services (HCBS) waivers.
- Coverage, eligibility, and services vary by state. Check with your local Medicaid office or Area Agency on Aging.
Private Insurance and Long-Term Care Insurance
- Most private health insurance plans offer limited home care benefits, usually only for short-term medical needs after hospitalization.
- Long-term care insurance policies are more likely to cover non-medical care, daily living assistance, and respite care. Read the policy carefully to understand limitations and exclusions.
Veterans Benefits
- The VA provides home care services for eligible veterans, including homemaker and home health aide care.
Paying Out of Pocket
If you don’t qualify for insurance or government programs, you can pay for home care privately. Many families combine several funding sources to cover all costs.
Tips for Maximizing Coverage
- Work with a care coordinator or social worker to explore all options
- Ask home care agencies if they accept your insurance
- Gather all medical documentation to support your need for care
For a complete guide on home care coverage and financial assistance, visit our Home Health Care for Seniors resource page.
