Your Medicare Coverage

Is your test, item, or service covered?

Home health services

How often is it covered?

Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) covers eligible home health services such as intermittent skilled nursing care, physical therapy, speech-language pathology services, continued occupational services, and more. Usually, a home health care agency coordinates the services your doctor orders for you. 

Medicare doesn't pay for:

Who's eligible?

All people with Medicare who meet the following conditions are covered:

  • The home health agency caring for you must be Medicare-certified.
  • Your doctor must certify that you're homebound.
  • You must be under the care of a doctor, and be getting services under a plan of care established and reviewed regularly by a doctor.
  • You must need, and a doctor must certify that you need, one or more of the following:
    • Intermittent skilled nursing care (other than just drawing blood)
    • Physical therapy, speech-language pathology, or continued occupational therapy services(covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must expected to improve in a reasonable and generally-predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition.)

You're not eligible for the home health benefit if you need more than part-time or "intermittent" skilled nursing care. 

Note: Home health services may also include medical social services, part-time or intermittent home health aide services, medical supplies for use at home, durable medical equipment, and an injectable osteoporosis drug.

Your costs in Original Medicare

  • $0 for home health care services.
  • 20% of the Medicare-approved amount for durable medical equipment.

Before you start getting your home health care, the home health agency should tell you how much Medicare will pay. The agency should also tell you if any items or services they give you aren't covered by Medicare, and how much you will have to pay for them. This should be explained by both talking with you and in writing. The home health agency should give you a notice called the Home Health Advance Beneficiary Notice (HHABN) before giving you services and supplies that Medicare doesn't cover.

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