Does Medicare Cover Home Health Care? 2026 Rules, $0 Cost
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Key takeaways
- Medicare covers home health care for a person who is homebound, is under the care of a doctor or allowed practitioner with a plan of care, and needs intermittent skilled nursing, physical therapy, speech-language pathology or continuing occupational therapy.
- CMS's homebound test has two parts: the person needs a device, special transportation or another person's help to leave home (or leaving is medically not advised), and leaving home takes a considerable and taxing effort.
- Medicare.gov says covered home health services cost $0. Covered medical equipment costs 20% of the Medicare-approved amount after the Part B deductible, which CMS set at $283 for 2026.
- Medicare does not pay for 24-hour care at home, meal delivery, homemaker services unrelated to the care plan, or personal care when that is the only care needed.
- When covered services are ending, the agency must give a Notice of Medicare Non-Coverage. The notice and Medicare.gov say to ask the Quality Improvement Organization for a fast appeal no later than noon of the day before the end date on the notice.
Short answer
Yes. Original Medicare covers home health care for a person who is homebound, is under the care of a doctor or allowed practitioner, and needs part-time or intermittent skilled nursing or therapy. Medicare.gov says you pay nothing for covered home health services. For covered medical equipment, you pay 20% of the Medicare-approved amount after the Part B deductible.
Find Medicare-certified home health agencies by ZIP code, with CMS star ratings and patient survey results where CMS publishes them.
Who qualifies for Medicare home health care?
Federal rules (42 CFR 409.42) say a person qualifies only when all of these are true:
- Homebound. The person is confined to the home (see the two-part test below).
- Under a doctor's or allowed practitioner's care. That doctor or practitioner sets up the plan of care.
- Needs a skilled service. This means intermittent skilled nursing, physical therapy or speech-language pathology. After an initial covered occupational therapy service, continuing occupational therapy also counts. Medicare.gov says it can continue on its own even when the other services are no longer needed.
- Has a plan of care. The care must follow a written plan.
- Uses a Medicare-participating agency. The agency gives the care or arranges it.
An in-person visit comes first. Medicare.gov says a doctor or other allowed provider must see the patient in person, certify the need for home health and order the care. CMS's Medicare Benefit Policy Manual says this face-to-face encounter must happen no more than 90 days before home health starts, or within 30 days after.
What does "homebound" mean for Medicare?
CMS's manual uses a two-part test: the person must meet at least one condition in Criterion One and both conditions in Criterion Two.
| Test | What CMS's manual says |
|---|---|
| Criterion One (meet one) | Because of illness or injury, needs a device such as a cane, walker or wheelchair, special transportation, or another person's help to leave home. Or leaving home is medically not advised. |
| Criterion Two (meet both) | There is a normal inability to leave home. And leaving home takes a considerable and taxing effort. |
The manual says leaving home for health care treatment, including regular treatment in an adult day-care program licensed or certified by a state, does not end homebound status. It treats trips to religious services as infrequent or short absences.
What does Medicare cover for home health, and what doesn't it cover?
Medicare covers skilled care in part-time or intermittent visits, but not round-the-clock or household help. This list is from Medicare.gov.
| Covered | Not covered |
|---|---|
| Part-time or intermittent skilled nursing | 24-hour-a-day care at home |
| Physical, occupational and speech-language therapy, if certain conditions are met | Home meal delivery |
| Medical social services | Homemaker services, like shopping and cleaning, unrelated to the care plan |
| Part-time or intermittent home health aide care, only if the person also gets skilled nursing or therapy | Custodial or personal care, like bathing or dressing, when it is the only care needed |
Medicare.gov also lists durable medical equipment and medical supplies for use at home as covered.
How many visits? Medicare.gov says an eligible person can get unlimited home health visits. In most cases, a person may be able to get skilled nursing and home health aide services combined up to 8 hours a day, for a maximum of 28 hours a week. For a short time, more frequent care (less than 8 hours a day and up to 35 hours a week) may be possible if the provider decides it is needed.
How much does Medicare home health cost in 2026?
Under Original Medicare, Medicare.gov says covered home health services cost $0. Costs that can still apply:
- Medical equipment: Medicare.gov says you pay 20% of the Medicare-approved amount for Medicare-covered medical equipment, after the Part B deductible. CMS set that deductible at $283 for 2026.
- Services and supplies Medicare doesn't pay for: a CMS booklet says you may have to pay for services Medicare never covers, like routine foot care, and for services you agree to pay for after the agency gives you an Advance Beneficiary Notice (see the ABN below).
The CMS booklet says the agency should tell you, before care begins, how much of the bill Medicare will pay. Federal rules (42 CFR 484.50) give the patient the right to be told, orally and in writing, how much Medicare is expected to pay, the charges for services Medicare may not cover, and the charges the patient may have to pay before care starts. The agency must share any changes as soon as possible, before the next visit.
Does Part A or Part B pay for home health?
Both can. Medicare.gov lists home health as covered by Part A and by Part B. For people with both parts, the Medicare law has Part A cover "post-institutional" home health for up to 100 visits. CMS's Medicare Benefit Policy Manual says this applies when the first covered visit is within 14 days after discharge from a hospital stay of at least 3 consecutive days, or from a skilled nursing facility stay for post-hospital care. Otherwise, and after those 100 visits, Part B pays, so a hospital stay is not required. Our home health vs. nursing home guide compares the two options after a hospital stay.
Medicare Advantage. Medicare.gov says people in a Medicare Advantage plan should check with the plan about home health benefits. A CMS booklet says the plan may require using home health agencies it contracts with.
What notices can a home health agency give you?
CMS describes three written notices: one before a charge, one before a cutback, and one before covered care ends.
- Advance Beneficiary Notice of Noncoverage (ABN). A CMS booklet says the agency must give this written notice before giving a service or supply that Medicare probably won't pay for.
- Home Health Change of Care Notice (HHCCN). The booklet says the agency must give this notice before it reduces or stops services in a way that changes the plan of care. Its examples: the agency makes a business decision to reduce or stop services, or the doctor or allowed provider changed or didn't renew the orders. CMS lists it as a notice for Original Medicare home health patients.
- Notice of Medicare Non-Coverage (NOMNC). CMS says this notice tells patients their Medicare-covered services are ending. CMS uses it in both Original Medicare and Medicare Advantage.
What happens when Medicare home health services are ending?
The agency must give the NOMNC in advance, and the patient can ask the BFCC-QIO for a fast appeal. Federal rules (42 CFR 405.1200 and 405.1202) say:
- The notice is due no later than 2 days before services end. If visits are more than 2 days apart, it is due no later than the next-to-last visit.
- For home health, the rule gives the right to a fast decision when the patient disagrees that services should end and a physician certifies that stopping them may put the patient's health at significant risk.
- To get a fast decision, the patient asks the Quality Improvement Organization (QIO) by noon of the calendar day after receiving the notice. The notice itself and Medicare.gov give the deadline as no later than noon of the day before the end date shown on the notice.
- The QIO decides no later than 72 hours after the request.
- The agency may not bill the patient for the disputed services until the fast review is finished.
- A late request is still accepted. The QIO decides as soon as possible, but the 72-hour timeline and the billing protection don't apply.
For the nursing home version of these rules, see nursing home discharge rules and how to appeal.
How do you find a Medicare-certified home health agency near you?
Medicare.gov says the provider who decides you need home health care should give a list of agencies that serve the area. The provider must say if their organization has a financial interest in any agency on the list. A CMS booklet says you have a say in which agency you use.
Our home health agency finder lists agencies that CMS reports served at least one patient in a ZIP code, A to Z, not ranked. Each agency page shows, as CMS published it:
- Quality of patient care star rating, 1 to 5 stars from 7 measures. CMS says it compares agencies with one another.
- Patient survey star rating from the Home Health CAHPS survey, for agencies with at least 40 completed surveys, and the share of patients who would definitely recommend the agency.
- Services offered, hospital use and Medicare spending.
Browse by state, for example home health agencies in Washington, Virginia, Connecticut or Colorado. The CMS booklet also says you can ask your State Survey Agency for the inspection report on an agency you are considering.
What rights do Medicare home health patients have?
Federal rules (42 CFR 484.50) require the agency to give a written notice of rights during the first evaluation visit, before care starts. Those rights include:
- Having your person and property treated with respect.
- Being free from abuse, neglect and misuse of your property.
- Taking part in, and agreeing to or refusing, your care and plan of care.
- Getting advance written notice when a service may not be covered, or when care will be reduced or stopped.
- Complaining about care without discrimination or reprisal.
- Being told about the state's toll-free home health hotline and the local QIO.
- Being told about language services and auxiliary aids, and how to get them.
Where can you get free help with Medicare home health?
Medicare and your State Health Insurance Assistance Program (SHIP) answer home health questions at no cost.
- 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) for coverage questions and your BFCC-QIO's phone number.
- SHIP. A CMS booklet says SHIP counselors answer questions about Medicare's home health benefits. Find yours at shiphelp.org or through 1-800-MEDICARE.
- State home health hotline for complaints about an agency. The CMS booklet says the agency should give you this number when services start.
Weighing a nursing home stay instead? See does Medicare cover nursing homes.