Medicare Home Health Coverage Explained
Eligibility, what's covered, what isn't, and how to avoid the most common billing surprises.
9 min read
Medicare home health coverage is generous but often misunderstood. Knowing the rules in advance prevents costly assumptions.
Eligibility requires that the beneficiary be homebound, under a physician's care, and need intermittent skilled nursing care or therapy. Care must be ordered by a physician and provided by a Medicare-certified agency.
Covered services include part-time skilled nursing, physical, occupational and speech therapy, medical social services and home health aide services tied to skilled care.
Not covered: 24-hour at-home care, meal delivery, custodial care alone, or homemaker services unrelated to a skilled care plan.
Reassessment occurs every 60 days. Continued eligibility requires documented ongoing skilled need and homebound status.
Medicare Advantage plans must cover at least the same services but can add supplemental benefits. Read the plan-specific rules.