Does Medicare Cover Home Health Aides

Medicare is U.S. government health insurance for senior citizens (or younger people with certain disabilities). Some Medicare patients who don't need hospital stays or nursing home visits may require other help, like assistance getting dressed and bathed. Home health aides can provide this assistance.

Conditions of Coverage

• Medicare may cover home health aides if you meet four conditions. First, a doctor must prescribe home health care for the patient and approve the care plan. Second, the patient must need at least one of the following on an intermittent basis: nursing care, physical therapy, or speech therapy. Third, the patient must be homebound and require a walker, cane, or wheelchair to get around when he or she leaves home. Finally, the home health services must come from an agency that is Medicare certified.

What Medicare Covers

• Medicare will pay for a licensed practical nurse, a registered nurse, a physical therapist, or a speech therapist. Home health aides who offer personal care to patients are covered if you are getting skilled care from a nurse or therapist.

What it Doesn't Cover

• Medicare will not cover around-the-clock home-health-aide care---only part-time or intermittent care is allowed. Medicare also won't cover house cleaning services.

What You Have to Pay

• There is a chance that some of the services may not be covered by Medicare. If this happens, you will get a notice called a Home Health Advance Beneficiary Notice. Home health equipment requires a 20 percent payment from the patient.

Finding Help

• Your home health provider must be Medicare certified. To find a home health agency that is certified, visit medicare.gov/HHCompare/Home.asp. Medicare inspects these agencies each year to make sure they continue to meet Medicare's standards.