Does Medicare Pay for Home Health Care After Hospitalization?

Click here to return to our Medicare FAQs page.

Medicare does provide coverage for home health care services after hospitalization, but there are specific criteria and limitations that beneficiaries must meet. Understanding the details of this coverage can help ensure that seniors receive the necessary care to recover at home effectively.

Medicare’s Coverage of Home Health Care:

Medicare covers home health care through its Part A and Part B benefits, depending on the circumstances. Part A typically covers home health services if they are needed after a hospital stay or a stay in a Skilled Nursing Facility (SNF). Part B covers home health care services without a preceding hospital stay if the care is medically necessary.

Eligibility Criteria:

For Medicare to cover home health care services, the following criteria must be met:

  1. Doctor’s Certification: A doctor must certify that the patient needs intermittent skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy.
  2. Care Plan: The home health agency providing the care must create a care plan and have it periodically reviewed by a doctor.
  3. Homebound Status: The patient must be considered homebound. This means it is difficult for them to leave home without assistance due to a medical condition, and they only leave home for medical treatment or infrequent non-medical reasons, such as attending religious services.
  4. Medicare-Certified Agency: The home health services must be provided by a Medicare-certified home health agency.

Services Covered:

Medicare covers a range of home health care services if the eligibility criteria are met. These services include:

  1. Skilled Nursing Care: This includes services that require the skills of a licensed nurse, such as wound care, injections, IV therapy, and monitoring of serious illness.
  2. Physical Therapy: Services designed to help patients regain mobility and strength after surgery, illness, or injury.
  3. Speech-Language Pathology Services: Therapy to help patients recover their ability to speak and communicate or address swallowing issues.
  4. Occupational Therapy: Services that help patients regain the ability to perform daily activities.
  5. Medical Social Services: These services help patients access community resources and support systems.
  6. Home Health Aide Services: Limited part-time or intermittent personal care services, such as bathing, dressing, and other personal hygiene tasks, provided these are part of the treatment plan for the patient’s condition.

Duration and Frequency:

Medicare’s home health care benefit is generally intended for intermittent care. This means the care is provided less than seven days a week or less than eight hours each day over a period of 21 days or less, with some exceptions for specific patient needs. This limitation is important to note, as it means Medicare does not cover around-the-clock home health care or long-term personal care.

Cost and Payment:

For those eligible, Medicare covers 100% of the approved amount for home health care services. There is no cost for covered home health care visits. However, beneficiaries might incur costs for additional medical supplies or equipment needed at home. Medicare Part B beneficiaries are responsible for 20% of the cost of durable medical equipment (DME), such as wheelchairs or walkers, after meeting the Part B deductible.

Post-Hospitalization Coverage:

When a patient is discharged from the hospital or SNF and requires home health care, Medicare Part A will typically cover the initial home health services if they are directly related to the hospital treatment. This transition from hospital to home care is crucial for ensuring continuity of care and supporting the patient’s recovery in a familiar environment.

Limitations and Considerations:

While Medicare provides significant support for home health care, there are limitations to be aware of:

  1. Non-Covered Services: Medicare does not cover 24-hour-a-day care, meals delivered to the home, or homemaker services like cleaning and laundry when these are the only services needed.
  2. Caregiver Support: While Medicare may cover home health aide services, these are limited in duration and must be related to the patient’s medical needs. Families often need to seek additional resources to cover long-term caregiving needs.
  3. Medicaid and Other Resources: For seniors requiring extensive or long-term home health care, Medicaid and other programs may offer additional support. Eligibility for Medicaid varies by state and involves different criteria.


Medicare provides highly limited coverage for home health care services following hospitalization. By meeting specific eligibility criteria and understanding the scope of covered services, beneficiaries can maximize the benefits available to them, recognize the limitations of Medicare coverage, and plan accordingly for comprehensive long-term care needs.