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Will Medicare Pay for Home Health Care Provided by a Family Member?
Date Updated: December 20, 2024
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Kristi Bickmann, a licensed Long-Term Care Specialist, represents top-rated "Traditional" & "Hybrid" LTC companies. Serving associations such as the American Nurses Association, she's a licensed insurance agent in 27 states. Specializing in insurance products for seniors, Kristi helps hundreds of families every year protect assets, retirement, and loved ones. She understands aging concerns firsthand, having assisted her own parents. Kristi ensures accuracy on topics about senior long-term care and its consequences.
Medicare won’t pay for home health care provided by a family member. The health insurance scheme funds doctor-ordered, medically necessary home health services provided by trained professionals. Home health care providers must hold Medicare certification to receive funding. Some states pay relatives to perform nonmedical home care tasks.
Home Health Care Overview
Temporary home health care services enable individuals to recuperate at home after an illness, injury or surgical procedure. After discharge from a hospital or nursing home, people may receive visiting support in their private homes. Some seniors require ongoing home health care support, for example, to help them manage chronic conditions.
Tailored support plans include medical and therapeutic services that target specific conditions or health care needs. Service examples include skilled nursing, rehabilitation therapies and dietary oversight. Home health care teams include trained professionals from diverse medical fields, including:
- Nurses
- Nursing aides
- Physical therapists
- Occupational therapists
- Speech-language therapists
- Dietitians
- Medical social workers
Medicare Funding of Home Health Care
Medicare pays for home health care under Part A and Part B. To qualify, seniors must meet functional need criteria and be homebound, and a physician must state that they need such services. Providers perform frequent eligibility reviews, and Medicare funding only continues for as long as a doctor prescribes care services. Medicare home health coverage includes:
- Part-time skilled nursing
- Occupational, physical and speech therapies
- Medical social services
- Durable medical equipment and supplies
- Intermittent personal care in limited situations
Because agencies must be Medicare-certified, and because Medicare requires medical professionals to perform home health care duties, relatives can’t receive payment to provide medical care. However, Medicare may fund patient and caregiver education, putting people in a better position to manage ongoing conditions, hasten their recovery and maintain healthier habits at home.
When Public Funding Pays Family Caregivers
No public assistance programs pay untrained individuals to provide clinical care. Moreover, Medicare doesn’t pay for nonmedical home care, except for personal aide assistance for those receiving skilled services. However, Medicaid pays family members to perform regular home care duties in some states. Financial assistance may come via state plans or waiver programs, depending on location.
Similarly, while the Veterans Administration only pays for professionally delivered home health care, it also pays a monthly stipend for eligible family caregivers who live with veterans and help them with day-to-day tasks and personal care.