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Does Medicare Cover Live-In Home Care?
Date Updated: December 20, 2024
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Sarah has produced thousands of articles in diverse niches over her decade-long career as a full-time freelance writer. This includes substantial content in the fields of senior care and health care. She has experience writing about wide-ranging topics, such as types of care, care costs, funding options, state Medicaid programs and senior resources.
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Dr. Brindusa Vanta is a health care professional, researcher, and an experienced medical writer (2000+ articles published online and several medical ebooks). She received her MD degree from “Iuliu Hatieganu” University of Medicine, Romania, and her HD diploma from OCHM – Toronto, Canada.
Medicare doesn’t cover live-in home care. The federal health insurance program doesn’t fund 24-hour care and only covers limited in-home care services. Instead, Medicare pays for part-time home health care, such as skilled nursing care and rehabilitation.
In-Home Care Versus Home Health Care
While in-home care helps seniors with activities of daily living, home health care provides medical care and therapies in an individual’s residence. The former focuses on practical day-to-day support and relieving loneliness. However, the latter delivers essential clinical and therapeutic services that would otherwise need to be provided in an inpatient or residential setting. Typical in-home care services include:
- Help with personal and oral care
- Assistance moving around the home and getting in and out of bed
- Toileting help
- Dressing assistance
- Meal preparation
- In-home enrichment activities, such as doing puzzles and playing games
- Housework and laundry
- Transportation
- Running errands, such as shopping and collecting medications
Conversely, home health care support plans often include:
- Skilled nursing, such as administering medications, changing wound dressings and monitoring health conditions
- Specialized care following a stroke, heart attack or injury
- Catheter changes
- Nutritional oversight
- Physical therapy
- Occupational therapy
- Speech-language pathology
- Medical social services
- Personal care
Medicare Coverage of Home-Based Care Services
Medicare pays for most home health services for qualifying individuals. Seniors must be homebound, and a doctor must order services they class as medically necessary. Financial assistance covers part-time in-home nursing and therapies. It only covers intermittent personal care aide support for individuals who also receive skilled services at their residences. Medicare doesn’t pay for personal care if that’s the only support an individual needs.
Moreover, Medicare never funds live-in care. The number of support hours it covers depends on an individual’s needs, but the program usually pays for up to 28 hours of care weekly. In exceptional situations, people may qualify short-term for a maximum of 35 hours per week.
Options to Explore for 24-Hour Care
Individuals use private funds to pay for around-the-clock in-home or home health care. However, with median hourly rates of $30 and $33 in 2024 for home care and home health care, respectively, self-funding 24-hour care at home is challenging for many older adults. Those who receive Medicare assistance for home health care could consider paying privately for additional care hours.
Alternatively, Medicaid may pay for 24-hour home health care. However, it generally won’t cover nonmedical live-in support. Those without clinical needs may qualify for Medicaid funding for nonmedical home care for several hours daily; they could then pay privately for extra hours to maintain continuous support. VA benefits pay for 24-hour home care for eligible veterans. Seniors who need 24/7 support might find that residential care settings, such as nursing homes or assisted living facilities, better match their needs and budgets.