Does Medicare Pay for Home Care?
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Short answer: Generally not for non-medical home care. Original Medicare covers home health, meaning part-time skilled care a doctor orders for someone who is homebound. It does not cover ongoing custodial help like bathing, dressing, meals, or 24-hour care when that's all you need (Medicare.gov). In Dallas, families usually turn to Texas Medicaid STAR+PLUS, VA benefits, long-term care insurance, or private pay.
What Medicare home health covers
According to Medicare.gov, covered services include part-time or intermittent skilled nursing, physical, occupational, and speech therapy, and medical social services. It also covers part-time home health aide care (help with bathing, walking, and similar tasks), but only while you also get skilled care.
- Homebound: leaving home isn't recommended or takes considerable effort and help.
- Ordered by a provider who sees you in person, and delivered by a Medicare-certified home health agency.
- "Part-time or intermittent" generally means up to 8 hours a day and 28 hours a week combined (more for a short time in some cases).
- You pay nothing for covered home health services. 20% coinsurance applies to medical equipment after the Part B deductible.
What Medicare doesn't pay for
- 24-hour-a-day care at home
- Home-delivered meals
- Homemaker services (shopping, cleaning) unrelated to your care plan
- Custodial or personal care (bathing, dressing, using the bathroom) when that's the only care you need
Medicare.gov also says Medicare doesn't pay for long-term care, whether in a nursing home or in the community (Medicare.gov, long-term care). That's why most non-medical home care agencies are paid privately or through the programs below.
Medicare Advantage: a caveat
Some Medicare Advantage (Part C) plans offer extra benefits that can include limited in-home support. These vary by plan and year and are usually limited in hours. Check your plan's Evidence of Coverage or call Member Services before you count on them. Medicare.gov's own advice is to check with your plan about home health benefits.
Alternatives that can pay for non-medical care
- Texas Medicaid STAR+PLUS: a Medicaid managed care program for adults 65+ and adults with disabilities. Its long-term services include help at home with daily activities, and you can have it alongside Medicare (Texas HHS). Apply at Your Texas Benefits or call 2-1-1.
- VA: eligible wartime veterans and surviving spouses may get the VA Aid & Attendance pension increase. Veterans enrolled in VA health care may qualify for VA homemaker and home health aide care.
- Long-term care insurance: check the policy's elimination (waiting) period and whether it covers home care.
- Private pay: about $30 an hour at the Texas median (see Dallas costs).
Details and income limits: paying for home care in Dallas. Free local help: Dallas Area Agency on Aging, 214-871-5065.
Frequently asked questions
Does Medicare pay for in-home caregivers?
Not for ongoing non-medical help. Medicare doesn't pay for 24-hour care at home, homemaker services, or custodial personal care such as bathing and dressing when that's the only care you need. It does cover part-time home health aide care when you also need skilled care (Medicare.gov).
Who qualifies for Medicare home health?
You must be homebound and need part-time or intermittent skilled care, such as nursing or therapy. A doctor or other provider must see you, confirm the need, and order the care, and a Medicare-certified home health agency must provide it (Medicare.gov).
Do Medicare Advantage plans cover home care?
Some Medicare Advantage plans offer extra in-home support benefits, but benefits vary by plan and year. Check your plan's Evidence of Coverage or call the plan. Medicare.gov says to check with your plan about home health benefits.
What pays for non-medical home care if Medicare doesn't?
Common options are Texas Medicaid STAR+PLUS (for people who qualify financially and medically), VA benefits for eligible veterans and surviving spouses (such as Aid & Attendance or VA homemaker and home health aide care), long-term care insurance, and private pay.
Related guides
Sources
- Medicare.gov, Home health services
- Medicare.gov, Long-term care
- Medicare.gov, Medicare & Home Health Care (PDF booklet)
- Texas HHS, STAR+PLUS
- VA.gov, Aid and Attendance benefits and Housebound allowance
- VA.gov, Homemaker and Home Health Aide Care
- Your Texas Benefits
Please note: This guide is general information for families, not medical, legal, or financial advice. Prices, ratings, and program rules change; confirm directly with agencies, the VA, and Texas HHS. We are brand-neutral and do not accept payment for placement.