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How Long Will Medicare Pay for Home Health Care?
Date Updated: January 10, 2025
Written by:
Lauren Thomas is a seasoned writer that specializes in long-term care, with a special focus on dementia-related topics. She holds a degree in counseling and uses her knowledge and experience to create insightful content that gives seniors and families the information they need to make important care decisions.
Reviewed by:
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 will pay for home health care services for as long as the beneficiary needs it, as long as it meets certain criteria. For you to receive ongoing services, your doctor must recertify your plan of care at least once every 60 days.
Home Health Care Services Explained
Home health care encompasses a broad range of health care services that medical professionals administer in the individual’s home following a significant injury or illness. In many cases, it offers the same effectiveness as services you receive in a hospital or skilled nursing facility, but it’s more convenient and generally more affordable. Home health care includes the following:
- Wound care for surgical wounds or pressure sores
- Health education
- Nutrition therapy
- Medication administration, including injectables
- Vitals monitoring
- Speech, occupational and physical therapies
Home health care helps manage injuries and illnesses, aiding the individual in recovering and maintaining as much self-sufficiency as possible. It can also help the individual retain their current level of functioning.
How Long Do Medicare Beneficiaries Qualify for Coverage for Home Health Care?
In most cases, Medicare pays for home health care for up to 21 days in a 30-day period. If your doctor certifies your need for it, you can have more than one 30-day period of care. During that period, you may only obtain services on a part-time or intermittent basis, which Medicare defines as:
- Fewer than eight hours per day
- 28 or fewer hours of care per week (though you may obtain approval for up to 35 hours of care in certain situations)
Medicare doesn’t pay for 24-hour care, and it doesn’t cover home health care long-term. Additionally, it doesn’t pay for nonmedical custodial services that aren’t linked directly to your health condition. For example, if you only need basic care such as bathing and dressing, Medicare won’t pay.
Choosing a Home Health Care Agency
If your health care provider certifies your need for home health care, choose a local Medicare-certified home health care agency. You must receive all necessary help from a single agency, though you may stop getting services from one agency and switch to another at any time. In most cases, Medicare-certified home health care agencies accept new clients with Original Medicare. However, if you have Medicare Advantage, you may need to choose from an approved provider from your plan’s network.
As you’re choosing a home health care agency, consider factors such as:
- Whether the agency provides the specific services you need
- How much the agency charges
- If the agency can connect you with community-based supports, such as home-delivered meals
- Whether the agency explains your insurance coverage and out-of-pocket costs
- Recommendations from your hospital discharge planner or health care provider