Medicare and In-Home Nursing Care

What It Is

Nursing care provided to a patient at home

What's Covered

Medicare Part A and Medicare Part B cover nursing care at a patient's home only as part of covered in-home care, prescribed by a doctor and provided by a Medicare-certified home healthcare agency.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for nursing care provided at home, contact the plan directly.

What Medicare Pays

Medicare Part B pays the full Medicare-approved amount for covered nursing care provided as part of in-home care by a Medicare-certified home healthcare agency.

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.

Was this medicareinformation helpful?

7 Comments So Far. Add Your Wisdom.

8 months ago

So far I cannot get straight answers and I to am ready for help as my spouses condition has worsened. I am gouing to keep trying. Waht amazes me is how un-knowledgeable most people are when one makes inquires.

almost 2 years ago

Dealing with 24/7/365 caregiving is tiring and stressful. Medicare will not pay for "assisted" living care "in" your home or in a facility. It will pay for "skilled nursing" care. Most dementia patients do NOT require "skilled nursing", therefore, there is no financial help from Medicare. My husband has dementia, COPD, BPPV, glaucoma, macular degeneration, osteoarthritis in his knee, high blood pressure, prostate cancer and a second pacemaker (within 5 months, due to infection of the 1st one). Medicare claims he does NOT require skilled nursing!

about 2 years ago

My husband can no longer be left alone. He needs constant suppervision. I NEED extra help, even at night.

over 2 years ago

I am going to inquire about medicare in care... Since I am the sole is 24/7/365

over 2 years ago

my husband and Ihave BCBS MEdicare HMO, does it cover in home care?

almost 3 years ago

I am wondering if Medicare covers for home care outside of the US. My Mom needs 24/7 care and she is leaving in CR after retiring there 20 years ago. I have never taken advantage of Medicare for her because she has lived in CR all these years but now that she needs more care I was wondering if they would cover it here.

about 3 years ago

Home care will probably be necessary at some point since my husband is too heavy for me to lift. He has been pretty functional but fell recently and I am getting a preview of what's in store down the road. It is so helpful to know about Medicare options. Thank you!


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