Does Medicare Cover Caregivers?

Many seniors rely on caregivers to help care for them through injuries or illnesses. However, this personal care can be quite expensive.

So a common question many people have is, “does Medicare cover caregivers?” In this article, we answer that question in clear, plain English. You will also find the average costs of caregiver care and other helpful info.

The short answer is yes; Medicare will cover the cost of caregiver care. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your caregiver care. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for caregiver care. However, Medicare does not provide coverage for all types of caregiver care. When it comes to home health care, both Medicare Part A and Part B provide coverage for the services and care.

But for Medicare Part A and Part B provide coverage for your home health care, you must meet at least one of these conditions:

You are unable to leave your home unless you need to go out on a short outing such as going to the doctor. Medicare will still cover your home health care even if you go to adult daycare
Your healthcare provider ordered home caregiver care. He/she must outline a plan on the type of care that you need
You need skilled nursing care. Medicare will only cover 8 hours of skilled nursing care in a day and 28 hours a week for up to three weeks
Your healthcare provider thinks that your condition will improve in a reasonable amount of time
You need physical, occupational, or speech therapy. Your healthcare provider must design a program to improve, maintain, or prevent your condition from getting worse
The home-health agency that will provide the in-home caregiver care is Medicare-approved

Some of the services that you may receive from an in-home caregiver care include:

Physical therapy
Occupational therapy
Speech therapy
Nursing care
Home-health aides

However, Medicare will not cover all types of caregiver care. Medicare does not provide coverage for custodial care unless you need it for a short time while you are recovering from an illness or injury. Custodial care includes care that is not medically necessary such as dressing and going to the bathroom.

Part C and Part D Coverage for Caregivers

Medicare Advantage plans (Medicare Part C) also provide coverage for caregiver care. They cover everything Original Medicare covers, as well as offer some additional benefits. However, exactly what it covers and what your out-of-pocket costs will be varies on the specifics of your plan.

If you need prescription medications during your home healthcare period, Medicare Part D will provide coverage.

How Much Does Caregiver Care Cost?

Caregiver care can cost $20 or more per hour. On average, a caregiver costs $4,000 per month. These costs will vary from state to state.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.