✔ Backed by: Centers for Medicare & Medicaid Services (Medicare.gov). Each fact links to its source, and the full list is at the bottom of this post.
When someone comes home after a hospital stay, a surgery, or a hard stretch with a long-term illness, home can feel like both a relief and a challenge. Who will check the wound? Who will help with the walker? Who will answer questions at 7 p.m. on a Tuesday? Medicare home health care can help answer those questions.
For many people with Medicare, home health care brings skilled care, like nursing and therapy, into your home for a period of time. But it is often misunderstood. Some families think it means a helper who stays all day. Others don’t know it exists at all. This post explains what Medicare home health is, who qualifies, what it does and doesn’t cover, and how to get it started.
What Medicare home health care is (and isn’t)
Medicare home health covers part-time or intermittent skilled care. That can include skilled nursing, such as wound care, teaching you and your caregiver, IV or nutrition therapy, injections, and watching a serious or unstable condition. It can also include physical therapy, occupational therapy, speech-language therapy, medical social services, and medical equipment and supplies for use at home.[1]
A home health aide can help with personal care, like bathing. But Medicare covers aide services only while you are also getting skilled care, such as nursing or therapy.[1]
Medicare home health does not cover 24-hour care at home or meal delivery. It also doesn’t cover homemaker services like shopping or cleaning that aren’t part of your care plan. Personal care like bathing and dressing isn’t covered either when that is the only help you need.[1] That last point matters. If what you need most is daily hands-on help, you may need other options too. A social worker can help you look at them.
Who qualifies under Original Medicare
Medicare lists a few key conditions. You need part-time or intermittent skilled services. You need to be homebound. A doctor or other allowed provider, such as a nurse practitioner, must see you in person and confirm you need home health care before it starts. And the care must come from a Medicare-certified home health agency.[1]
“Homebound” is the word that confuses people most. Medicare describes two parts, and both need to be true. First, leaving home isn’t recommended because of your illness or injury. Or you have trouble leaving without help, like a cane, walker, wheelchair, or crutches, special transportation, or another person. Second, you are normally unable to leave home, and leaving takes a lot of effort. You can still leave home for medical care and for short, infrequent non-medical outings and still count as homebound. Going to adult day care also doesn’t disqualify you.[1]
Think of Ray, who just had a knee replacement. He can walk to the bathroom with a walker. But getting down his front steps and into a car takes his son’s help and wears him out. He still goes to his follow-up visits. Ray may be considered homebound, even though he does leave the house sometimes.
If you have a Medicare Advantage Plan, the rules and the list of agencies you can use may be different. Medicare suggests checking with your plan about your home health benefits.[1]
What it costs
For people who qualify, Medicare says you pay nothing for covered home health services. For Medicare-covered medical equipment, you generally pay 20% of the Medicare-approved amount after you meet the Part B deductible.[1]
The agency should tell you ahead of time what Medicare will pay for and what it won’t. Before giving you items or services that Medicare doesn’t cover, the agency should give you a written notice called an Advance Beneficiary Notice.[1] If you see a charge you don’t understand, ask about it before you agree.
How to get Medicare home health care started
Home health usually starts with a conversation, often in the hospital before you go home, or at a visit with your doctor. You can bring it up yourself. You don’t have to wait for someone to offer it.
You can say: “I’m worried about managing at home. Do you think I need home health care, like nursing or physical therapy? Could you order it for me?”
Once your provider orders care, a plan of care is made. Medicare’s home health booklet says this plan lists the services you need and who will provide them. It also lists how often you will get them, the equipment you need, and the results your provider expects. Your provider and the home health team must review the plan at least once every 60 days.[2]
You have a say in which agency you use
Many people don’t know this: Medicare says you have a say in which agency you use, and your doctor or hospital discharge planner should respect your choice. Medicare pays one home health agency at a time, and you can switch agencies by getting a referral to a new one. Your choices may be limited by which agencies serve your area or by your plan’s network.[2]
You can search for Medicare-certified home health agencies near you with Medicare.gov’s Care Compare tool.[3] The Medicare booklet also suggests asking agencies questions like these:[2]
- Are you Medicare-certified? (And Medicaid-certified, if you have both?)
- Do you offer the services I need, like nursing or physical therapy?
- Can you meet my language or cultural needs?
- Can you start when I need you, and provide the hours my provider ordered?
- Is someone available at night and on weekends if there’s a problem?
Asking about language and culture is not a small thing. It is part of getting care that feels respectful and works for your household, whoever is in it.
Your rights when care changes or ends
You have the right to be told in advance about your care and about changes to your plan of care. Before an agency reduces or stops services in a way that changes your plan, it must give you a written Home Health Change of Care Notice.[2]
When Medicare-covered home health services are ending, you should get a Notice of Medicare Non-Coverage at least 2 days before they end. If you think services are ending too soon, you can ask for a fast appeal. Follow the instructions on that notice, no later than noon the day before the end date. The appeal goes to an independent reviewer called a BFCC-QIO.[4]
You can say: “I don’t feel ready for my services to stop. Can you show me how to request a fast appeal?”
Tru-Tips: Keep a simple notebook by the door for home health visits. Ask each visitor to jot down their name, the date, what they did, and when they’ll be back. It helps you, your family, and your doctor see the whole picture.
One Tru Step: If you or someone you care for has a hospital stay or surgery coming up, write down this one question to ask before discharge: “Will I need home health care, and who will order it?”
Let’s talk
Have you had home health visits after a hospital stay? What helped the most, and what do you wish you had known at the start? Share your experience in the comments.
Sources and further reading
- Medicare.gov: Home health services
- Medicare.gov: Medicare & Home Health Care (booklet)
- Medicare.gov: Care Compare, home health agencies
- Medicare.gov: Getting a fast appeal from non-hospital settings
Sources checked October 17, 2026. General education; individual care and coverage questions require an appropriate professional.
Related Health Hubs
- Home Health, Hospice and Palliative Care
- Post-Discharge Recovery
- DME, Home Safety and Rehabilitation
- Caregiver Support
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