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Does Medicare Cover Nonmedical Home Care?
Date Updated: December 9, 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 nonmedical home care, except for limited services in specific situations. Generally, the federal health insurance program only covers clinical and therapeutic care in a person’s private residence. However, funding sometimes includes personal care aide assistance for those receiving skilled services.
Nonmedical Home Care Versus Home Health Care
Despite both supporting seniors aging in place, in-home and home health care agencies provide different services. Regular home care assists seniors with domestic chores and personal care. Tailored plans also include companionship hours, whereby aides or volunteers provide company and facilitate at-home leisure activities. Common services include:
- Personal care, including bathing, dressing, toileting and grooming
- Housework, laundry and light gardening
- Grocery shopping and meal preparation
- Medication reminders
- Prescription pickups
- Transportation
- Companionship
In contrast, home health care includes medical and rehabilitative services that a professional team delivers. Agencies provide personal care to support seniors in maintaining bodily and oral hygiene. Home health service plans include:
- Intermittent skilled nursing, such as wound care and IV therapy
- Medication administration
- Catheter care
- Speech, occupational and physical therapy
- Dietitian support
- Medical social services
- Medical transportation
- Personal care assistance
Medicare Coverage of Care at Home
Medicare covers part-time home health care services under both Part A and Part B. Individuals must be homebound and have a medical need for care at home. Additionally, a doctor must prescribe services. Covered services include:
- Skilled nursing
- Rehabilitation therapies
- Medical social services
- Medical supplies and equipment for eligible individuals
Medicare only covers assistance with specific activities of daily living for those who also need skilled nursing care or therapeutic support. Such services include:
- Ambulation support
- Feeding help
- Bathing assistance
- Dressing assistance
- Sheet-changing
Medicare never pays for homemaker assistance or companionship. Moreover, if a doctor no longer deems home health care as medically necessary, all services end. This includes home health aide support for seniors previously receiving skilled in-home care.
Paying for Nonmedical Home Care
Most home care recipients don’t receive financial assistance via Medicare, so they must consider other ways to fund in-home support services. Those who meet functional and financial criteria may qualify for Medicaid or waiver programs to help lighten their economic load. VA benefits pay for in-home attention for eligible veterans. Other methods of payment include:
- Private pay from individuals’ own pockets or families
- Long-term care insurance
- Reverse mortgages