Coverage

Does Medicare Cover Home Health Care?

Christian Worstell

by Christian Worstell | Published October 08, 2020 | Reviewed by John Krahnert

Medicare does cover home health care as long as it is deemed medically necessary by a doctor.

A Medicare Supplement (Medigap) plan can help cover your home health care Medicare costs, which can include out-of-pocket costs like deductibles, coinsurance, copays and more.

Doctor smiles as she speaks with her patientA Medigap plan can help cover your home health care Medicare costs.

When Does Medicare Pay for Home Health Care?

Many health care services that were once only available in a doctor’s office or hospital are now available at your home. This form of care, known as home health care, can encompass a wide range of treatments and services. 

Original Medicare (Part A and Part B) covers care at your home in certain circumstances, including:

  • Intermittent skilled nursing care (less than seven days a week; or less than 8 hours a day over a maximum of 21 days)

  • Physical therapy

  • Speech-language pathology care

  • Occupational services

  • Medical social services

Once your doctor refers you to a home health care agency, the agency will come to your home and administer care as often as directed by your doctor. The home health agency will also regularly update your doctor on your progress. 

To receive skilled nursing care at home, you must be homebound and not require full-time care.

How Much Does Home Health Care Cost With Medicare? 

Typically, the costs of home health care services covered by Original Medicare are as follows:

  • $0 for home health care services

  • 20% of the Medicare-approved amount for durable medical equipment

Keep in mind that you are still responsible for your Original Medicare out-of-pocket costs, which include your Medicare Part A and Part B deductibles, coinsurance and copays. 

How Do I Start Getting Home Health Care?

Before you begin receiving home health care, your home health agency will schedule a time to visit your home.

During this appointment, you’ll discuss your health care needs, and you’ll have the opportunity to ask questions about your health care services. The home health agency will also talk with your doctor about your care to ensure everyone is on the same page.

Once treatment begins, your home health care provider will also:

  • Ask about the food you eat

  • Check your vital signs (blood pressure, temperature, heart rate, and breathing)

  • Discuss with you the medications you’re taking

  • Teach you about any steps you need to take in order to stay healthy

Medicare Covers Skilled Nursing Facility Care

If a beneficiary is an inpatient at a skilled nursing facility (SNF), Medicare may provide coverage for up to 100 days for the cost of:

  • Semi-private rooms
  • Meals
  • Physical and occupational therapy
  • Speech and language pathology services
  • Medications
  • Ambulance transportation
  • Other services and costs

A daily coinsurance fee of $176 (for 2020) is charged beginning on day 21 of an inpatient stay at a skilled nursing facility. 

Find Medigap Plans That Help Cover Your Home Health Care

If you home health care that is covered by Medicare, you may likely face out-of-pocket Medicare costs such as deductibles, coinsurance and copayments.

A Medicare Supplement Insurance plan can help cover some of these costs.

For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered home health care.

Learn more about Medicare coverage of common procedures

A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

 

Find Medigap plans that help pay for home health care.

Compare Plans
Or call 1-800-995-4219 to speak with a licensed insurance agent.

 

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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