Does Medicare pay for home care?

The short answer, and why it is two answers

“Home care” covers two different things in everyday use, and Medicare treats them nothing alike. The first is home health care: a nurse or therapist comes to the house to treat a medical condition, on a plan a doctor has ordered. Medicare.gov lists this as covered by both Part A and Part B, and says you pay nothing for covered home health services. The second is the help most families are actually shopping for, an aide who comes so that someone can bathe, dress and eat safely. Medicare.gov excludes that when it is the only care needed, and calls it custodial or personal care.

So the same visit can be partly covered and partly not. A nurse checking a surgical wound and teaching a family member how to change the dressing is skilled care. An aide helping the same person shower, on a day when no skilled need remains, is not. The billing follows the reason for the visit, not the fact that someone came to the house.

Nothing on this page changes the monthly cost survey figures below. Medicare does not set the hourly rate for private home care; it either covers the service or it does not. When it does not, the hours are bought at market rates.

Where the 100 days actually comes from

This is the most common mix-up in the whole subject, so it is worth stating in the sentences Medicare.gov uses. On the skilled nursing facility page: Part A limits skilled nursing facility coverage to 100 days in each benefit period. On the home health page, the sentence about limits reads differently: if you qualify, you can get unlimited home health visits.

Both statements are true, and they are about two different benefits. A benefit period, as Medicare.gov defines it, begins the day you are admitted as an inpatient in a hospital or a skilled nursing facility and ends when you have gone 60 days in a row without any inpatient hospital care or skilled care in a facility. The 100 days are counted inside that window, in a facility bed. Home health does not run on benefit periods at all.

Where the confusion costs families money is at the transition. A person leaves the hospital, uses part of the 100 in a skilled nursing facility, and then goes home with the same medical need. At that point the relevant limit changes from days in a building to hours in a week. The nursing home version of this question works through the day-by-day cost of the facility benefit and what happens on day 101.

The two conditions: a skilled need, and homebound

Medicare.gov requires both, and it is worth reading the second one closely because it is where applications fail. The first condition is that you need part-time or intermittent skilled services. Medicare.gov adds that you will not qualify if you need more than part-time or intermittent skilled care, which is a counterintuitive point: needing round-the-clock care at home does not make Medicare pay for more, it makes home health the wrong programme.

The second condition is being homebound, and Medicare.gov defines it as meeting both of two tests. Leaving home is not recommended because of your condition, or you have trouble leaving home without help, such as a cane, wheelchair, walker or crutches, special transportation, or help from another person, because of an illness or injury. And you are normally unable to leave home, and leaving takes a lot of effort. The page also allows medical trips and short, infrequent non-medical absences such as attending religious services, so homebound does not mean confined to a chair.

Two procedural facts sit in front of the coverage. A doctor or another provider such as a nurse practitioner must see you in person and confirm you need home health care, then order it, and the care has to come from a Medicare-certified home health agency. If occupational therapy is part of the plan, Medicare.gov says your provider must first order it along with nursing care, physical therapy or speech-language pathology; after that you can keep getting occupational therapy on its own even when the others stop.

What is covered, and the weekly hour limit

Medicare.gov lists the covered services on the home health page. Skilled nursing care that is medically necessary and part-time or intermittent, including wound care for pressure sores or a surgical wound, patient and caregiver education, intravenous or nutrition therapy, injections, and monitoring a serious illness or unstable health status. Physical therapy, occupational therapy and speech-language pathology services if you meet certain conditions. Medical social services. Injectable osteoporosis drugs for women who meet certain criteria. Durable medical equipment and medical supplies for use at home.

Home health aide care is on the list, with a condition attached that families miss: Medicare.gov covers it only if you are also getting skilled nursing care, physical therapy, speech-language pathology services or occupational therapy at the same time. The aide services covered in that situation are help with walking, bathing or grooming, changing bed linens, and feeding.

The limit on all of it is stated in hours. In most cases, Medicare.gov defines part-time or intermittent as skilled nursing care and home health aide services combined up to 8 hours a day, for a maximum of 28 hours a week. More frequent care is possible for a short time, less than 8 hours a day and up to 35 hours a week, if your provider decides it is necessary. There is no cap on the number of visits, so a person can be in the programme for a long time as long as each week stays inside the hour limits and the skilled need continues.

What that costs, from Medicare.gov: $0 for covered home health services, and after you meet the Part B deductible, 20% of the Medicare-approved amount for durable medical equipment. The 2026 Part B figures on Medicare.gov are a $203 monthly premium and a $283 deductible.

The gap: what Medicare will not pay for at home

Medicare.gov lists four exclusions that between them describe most of the bill a family actually faces: 24-hour-a-day care at your home, home meal delivery, homemaker services such as shopping and cleaning that are unrelated to your care plan, and custodial or personal care that helps with daily living activities such as bathing, dressing or using the bathroom, when this is the only care you need.

Those hours are bought privately, and the cost survey this site uses puts the 2025 national median for a non-medical caregiver at $35 an hour. At that rate the 28-hour weekly ceiling Medicare works within is about $980 of care a week, which is roughly $6,673 a month at the survey's own 44 hours a week, or $80,080 a year. Cover the clock instead of a working day and the arithmetic changes shape entirely: 24 hours a day, seven days a week at the same hourly rate comes to $5,880 a week, about $25,480 a month.

That last figure is why home care stops being the cheap option somewhere in the middle of the range, and why the comparison with a facility is not as simple as one hourly rate against one monthly rate. A nursing home's published median of $9,581 a month includes nursing, meals, the room and 24-hour supervision; hourly home care at a lower rate buys only the hours you pay for. The break-even comparison between the two works out where they cross over, and the in-home care cost page prices it hour by hour.

When Medicare's home health benefit does not fit, the options are the person's own money, a state Medicaid programme if the person qualifies under that state's rules, a long-term care insurance policy if one exists, or veterans benefits. Those are the same payers that fund assisted living, and the monthly invoices at home behave like the ones in a community once the care is not skilled: they exclude medication management, transport and the add-ons. The list of what a quoted care rate does not include applies to that budget wherever it is spent.

Four calls that settle your own case

1. The doctor who orders the care. Ask for the skilled reason in writing: what is being treated, and why it needs a nurse or therapist rather than an aide. That reason is what the agency bills against, and it has to be renewed when the need changes.
2. The home health agency, before the first visit. Medicare.gov says the agency should tell you how much Medicare will pay before care starts, and should give you an Advance Beneficiary Notice both verbally and in writing if Medicare will not pay for items or services they are giving you. Ask for that notice in writing rather than settling for a verbal estimate.
3. The agency or a private-duty company, on the hours. Ask which weeks are running at the 28-hour limit and what the hourly rate becomes on the hours Medicare does not cover. That answer, not the rate quoted for skilled visits, is your real monthly number.
4. Your state Medicaid agency, if the hours are growing. Ask whether the state has a home- and community-based services programme that pays for personal care hours at home, and how long the waiting list is. Eligibility is state-specific, so nothing you read about another state answers it.

One more thing worth saying plainly: as long as the skilled need continues and the hours stay inside the weekly ceiling, there is no day count running down. The thing to watch is the official reason on the paperwork, because that is what ends the benefit, not a calendar.

Where these numbers come from

Every Medicare rule and dollar amount on this page was read from Medicare.gov on the day it was published. The home health services page supplied the list of covered services, the four exclusions, the definition of homebound, the in-person provider visit requirement, the rule that home health aide care requires concurrent skilled care, the statement that you can get unlimited visits if you qualify, the 8-hour day and 28-hour week definition of part-time or intermittent, the 35-hour short-term exception, the $0 for covered services and the 20% for durable medical equipment, and the statement that attending adult day care does not disqualify you. The skilled nursing facility care page supplied the 100-day benefit period limit and the 3-day qualifying hospital stay. The Medicare costs page supplied the 2026 Part B premium and deductible. Care costs are the national medians published by the cost survey named above, and the weekly and monthly dollar figures derived from the hourly rate are arithmetic on that survey's own inputs rather than quoted figures. No other numbers are used on this page.