Does Medicare Part A Cover Home Health Care?

Medicare Part A covers home health care services. This coverage enables you to pay for skilled nursing services you need at home, letting you shorten the duration of hospital stays and, in some cases, avoid costly nursing home bills. However, for Medicare to pay for the home health care services you receive under Part A, you must meet certain requirements.

Original Medicare features three parts: Parts A, B and D. Part A, also referred to as hospital insurance, pays for inpatient hospital care as well as services you receive in skilled nursing facilities. With this coverage, you can receive services from any doctor, hospital or health care provider that accepts Medicare.

Those already drawing Social Security benefits receive automatic enrollment into Medicare Part A when they turn 65. As long as you or your spouse paid Medicare taxes for at least 10 years while working, you won’t have to pay a premium to receive Part A coverage. If you don’t qualify for premium-free Part A, as of 2024, you may be able to purchase it for a monthly premium of $278 or $505.

Medicare Part A provides 100% coverage for home health care services when you obtain care from a Medicare-approved home health care agency. While home health care coverage typically falls under Part B, Part A pays for services after you’ve spent at least three consecutive days in an inpatient hospital setting or skilled nursing facility. Under these conditions, Medicare Part A covers your first 100 days of home health care. If you need services beyond this time frame, your Part B coverage pays for care.

Along with having stayed in a hospital or skilled nursing facility, you must meet other eligibility criteria to receive Part A coverage for home health care services. For example, you must be homebound, meaning that leaving home is inadvisable or extremely difficult due to an injury or illness. Your doctor must also certify your need for intermittent or short-term skilled nursing services at home.

The home health care services you qualify for under Medicare Part A depend on your specific needs. The most common services include:

• Medication administration, including injections
• Physical and occupational therapies
• Speech-language pathology
• Medical social services
• Wound care
• Nonemergency medical transportation
• Catheter care
• Feeding tube maintenance
• Diabetes management
• Disease monitoring and management

Medicare Part A covers short-term services, typically no more than 35 hours per week. If you need home-based services beyond Medicare’s scope of coverage, you may need to explore other payment options such as long-term care insurance, life insurance benefits or Medicaid.