What Medicare Doesn’t Cover at Home

And what it does cover, who qualifies, and other ways families pay for help

Many families assume Medicare will pay for help at home once a parent can’t manage alone. It usually won’t. Medicare pays for short-term skilled care at home, not the day-to-day help most families need. Here’s exactly where the line falls.

What Medicare Doesn’t Cover at Home

Medicare lists these home services as not covered: (Source: Medicare.gov)

• 24-hour-a-day care at home. Medicare won’t pay for round-the-clock caregivers.
• Home meal delivery.
• Homemaker services, like shopping and cleaning, that aren’t part of your care plan.
• Personal care that helps with daily activities like bathing, dressing, and using the bathroom, when that’s the only care you need.

Companionship and supervision for someone with memory loss fall in the same group: they’re non-medical, so Medicare doesn’t pay for them on their own.

What Medicare Does Cover at Home

If you qualify, Medicare home health can cover: (Source: Medicare.gov)

• Part-time or intermittent skilled nursing care, such as wound care, injections, and IV or nutrition therapy
• Physical, occupational, and speech therapy
• Medical social services
• A part-time home health aide, but only while you’re also getting skilled nursing or therapy
• Medical equipment and supplies for use at home

You pay nothing for covered home health services. For covered medical equipment, you pay 20% of the Medicare-approved amount after the Part B deductible. (Source: Medicare.gov)

Who Qualifies for Medicare Home Health

Medicare says you must meet all of these: (Source: Medicare.gov)

• You need part-time or intermittent skilled services.
• You’re homebound: leaving home isn’t recommended, or it’s hard and takes a lot of effort because of an illness or injury.
• A doctor or other provider sees you in person and orders the care.
• A Medicare-certified home health agency provides it.

Why This Matters After a Hospital Stay

After a hospital stay, Medicare home health often sends a nurse or therapist for a few weeks. When those skilled visits end, many families find their loved one still can’t bathe, cook, or stay safe alone, and Medicare won’t pay for that ongoing help. Planning for it before discharge avoids a scramble. See our guide to home care after hospital discharge in Charlotte.

Not sure which kind of care you need? Our guide to home care vs. home health care explains the difference.

Other Ways to Pay for Help at Home

• Private pay. Typically $28–$36 an hour in the Charlotte area. See what home care costs in Charlotte.
• Long-term care insurance. Most policies pay for in-home personal care once you meet the policy’s benefit trigger.
• VA benefits for eligible veterans.
• NC Medicaid for people who qualify, through Personal Care Services or the CAP/DA waiver.

Our side-by-side guide, LTCI vs. VA vs. Medicaid: which pays for home care in NC?, compares them.

Frequently Asked Questions

Does Medicare pay for home care?

Not for ongoing personal care or companionship. Medicare pays for part-time skilled nursing or therapy at home for people who are homebound, when a doctor orders it.

Does Medicare pay for 24-hour care at home?

No. Medicare lists 24-hour-a-day care at home as not covered.

Does Medicare cover a home health aide?

Only part-time, and only while you’re also getting skilled nursing or therapy. Medicare doesn’t cover an aide when personal care is the only help you need.

How much do I pay for Medicare home health?

Nothing for covered home health services. For covered medical equipment, you pay 20% of the Medicare-approved amount after the Part B deductible.

How do families pay for non-medical home care?

Most use private pay, long-term care insurance, VA benefits for eligible veterans, or NC Medicaid for people who qualify.