Does Medicare Cover Home Health Aides?

Many seniors are dependent on home health care when it comes to their daily and medical needs. And between staying in an assisted living facility and having a home health aide, home health care is the cheaper option. That makes home health care very important to the lives of many seniors.

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

Does Medicare Cover Home Health Aides?

The short answer is yes; Medicare will cover the cost of your home health aide. 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 home health 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 home health care. However, not all types of home health care is covered by Medicare. Medicare Part A and Part B provide coverage for the services of your home health aide if you are injured or ill and you require their assistance.

Coverage for the expenses for your home health aide is provided by Medicare Part A and Part B. Medicare Part A and Part B provide coverage for the services of your home health aide if you are injured or ill and you require their assistance.

For Medicare Part A and Part B to provide coverage for your home health care, at least one these conditions must be met:

You cannot leave your home unless you need to go on a short outing such as visiting your doctor. Medicare will still cover your home health care even if you go to an adult daycare
Your healthcare provider orders that you need home health care. He/she must write an outline for the kind of care that you need
You require skilled nursing care. But skilled nursing care can only last for 8 hours per day and 28 hours per week for up to three weeks
Your healthcare provider believes that you will recover from your condition in a reasonable amount of time
You need physical, occupational, and/or speech therapy to maintain or improve your condition or prevent it from worsening
Your home-health agency is Medicare-approved

Some of the services that you may receive during home health care include:

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

Though Medicare Part A and Part B cover home health aides, they do not provide coverage for custodial care. They will only cover custodial care if you need it for a short period while you recover from an injury or illness.

Part C and Part D Coverage for Home Health Aides

Medicare Advantage plans (Medicare Part C) also provide coverage for home health aides. They cover everything Original Medicare covers, but usually offers some additional benefits as well. However, exactly what it covers and what your out-of-pocket costs are will vary depending on the specifics of your plan.

Medicare Part D is a prescription drug plan and does not cover home health aides. However, they provide coverage for prescription drugs that you need during your home healthcare period.