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Which Portion of Medicare Covers Home Health Care Services?
Date Updated: December 10, 2024
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.
The Part A and Part B portions of Medicare cover home health care services. This care type helps seniors reduce how much time they spend in a hospital setting and avoid or delay nursing home placement. Medicare Part and Part B let you obtain the skilled nursing services you need at home from any health care provider that accepts Medicare.
What Are the Parts of Medicare?
Medicare features three main parts, including Part A (hospital coverage), Part B (medical coverage) and Part D (prescription drug coverage). While these are all parts of Medicare, you purchase them separately, and each part has its own premium and deductible. Alternatively, you can choose to receive your Medicare benefits through Medicare Advantage, also called Part C, which offers Medicare coverage through private health insurance companies.
For example, beneficiaries who paid (or whose spouses paid) Medicare taxes for at least 10 years don’t pay a premium for Part A coverage. In 2024, this coverage has a $1,632 deductible individuals must pay before Medicare covers services, though you don't need to satisfy your deductible to receive covered home health care services. By contrast, Part B has a monthly premium of $174.70 (or higher, depending on income) in 2024, and it has an annual deductible of $240.
How Does Medicare Cover Home Health Care Services?
Your eligibility criteria determines which part of Medicare pays for home health care services. Medicare Part B covers home health care if you're homebound and need skilled care, regardless of prior hospitalization. Medicare Part A covers home health care if you're also receiving Medicare-covered inpatient hospital or skilled nursing facility care. These services may include:
- Wound care, including surgical wounds and pressure sores
- Rehabilitative therapies
- Medication administration
- Injections
- Disease monitoring and management
- Vitals monitoring
- Nonemergency medical transportation
How Long Can I Receive Home Health Care through Medicare?
Medicare pays for home health care services for beneficiaries who need short-term or intermittent care, which Medicare defines as:
- Fewer than eight hours per day
- 28 or fewer hours per week (or up to 35 hours per week for those who need fewer hours of care per day)
- 21 days or less per 30-day period
You can have more than one 30-day period of care. However, if you need more than intermittent skilled nursing services or your doctor expects you to need full-time skilled nursing over an extended period, you may not qualify for home health benefits under Medicare.