To qualify for home healthcare under Medicare, you’ll need to show that you are “homebound” due to illness and injury via a doctor’s examination and recommendation. However, you’ll first need to be enrolled in Medicare to be eligible for coverage.
Medicare provides coverage for a range of home health services as long as they are considered reasonable and medically necessary for treating an illness or injury.
It generally covers up to 8 hours per day and 28 hours per week of care, though this may extend to 35 hours per week in certain cases.
Read on to learn about how to qualify for home healthcare under Medicare, what kind of care you can expect, and how much you might pay out of pocket.
How do I qualify for home healthcare under Medicare?
Original Medicare (Part A and B) may cover home healthcare if you need part-time or intermittent care and are considered homebound. This means you are unable to leave your home without help due to illness or injury, have a doctor’s recommendation to limit leaving your home, or experience significant effort in doing so.
Just keep in mind that Medicare won’t cover non-medical home care services unless they are needed alongside other medical home healthcare services.
Non-medical home care services that aren’t covered include:
- meal deliveries
- round-the-clock home care
- homemaker tasks like shopping or cleaning that are unrelated to your care plan
- custodial or personal care, such as bathing or dressing
»Learn moreWhat home health services are covered by Medicare?
»MORE:Does Medicare Cover Home Health Aides?
What is the process to get home healthcare through Medicare?
To receive home healthcare through Medicare, you first need to enroll in Medicare. You’re generally eligible for Original Medicare if you’re 65 years old or above, receive Social Security Disability Insurance (SSD), or live with certain conditions.
If you qualify by age, you’ll need to enroll manually. If you qualify based on disability, you’ll be automatically enrolled. If you need to enroll manually, remember to keep the Medicare enrollment periods in mind.
Once you’re enrolled in Medicare, a Medicare-approved doctor or healthcare professional will need to examine you in person and certify that home healthcare is necessary.
»Learn more:Can You Get Medicare If You’re Under 65?
»Learn more:How to Verify Your Medicare Eligibility
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Medicare Costs Defined
How much does Medicare pay for in-home healthcare?
Medicare pays your Medicare-approved home health agency in one set amount for the care you receive over a 30-day period, and you can have more than one of these periods if needed.
The payment amount depends on your health and the type of care you require. That said, if your home healthcare is covered and you use a Medicare-certified home health agency, you usually won’t have to pay anything out of pocket.
However, remember that Medicare’s home health benefit only covers services provided by the agency itself. This means other medical services and equipment are usually covered under your regular Medicare benefits. For example, if you need medical equipment, Medicare Part B will cover 80% of the cost once you meet your annual deductible. In 2025, this is $257. In addition, you need to pay the monthly premium, which starts at $185, depending on your income.
If you’re enrolled in a Medicare Advantage (Part C) plan, you should receive equivalent coverage. However, your premium and deductible will vary depending on the plan. Also, to remain enrolled in a Part C plan, you still have to pay the Part B premium. However, some Part C plans may reimburse all or some of this cost.
Takeaway
Medicare covers medically necessary home health services, usually up to 8 hours per day and 28 hours per week, and in some cases, this extends to 35 hours. To qualify, you must be considered “homebound” and have a Medicare-approved doctor certify your need for care.
In addition, you must be enrolled in Medicare. Most people qualify at the age of 65, though those with disabilities or certain conditions may be eligible earlier. Enrollment is automatic with SSDI, but otherwise, you must do so during enrollment periods.
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Last medically reviewed on September 8, 2025
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Current Version
Sep 8, 2025
Written By
Alina Sharon
Edited By
Alina Sharon
Medically Reviewed By
Oluwatoyin Kuloyo, Pharm.D., BCPS
Copy Edited By
Matt Ng
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Reference: Medically reviewed by Oluwatoyin Kuloyo, Pharm.D., BCPS — Written by Alina Sharon on September 8, 2025
Medically reviewed by Oluwatoyin Kuloyo, Pharm.D., BCPS — Written by Alina Sharon on September 8, 2025
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