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If you look at the Medicare & You handbook for 2024 and read the section on home health, Original Medicare DOES cover a home health aide (personal care) IF you are homebound (need cane, wheelchair, walker, etc. to leave the home) and you need a skilled service, either skilled nursing care or one of the skilled therapies.

Medicare covers no more than 8 hours per day and 28 hours of week, up to 35 in certain circumstances, for skilled nursing and a home health aide combined.

The therapy visits are not subject to the 28 hour per week limitation, only the skilled nursing and home health aide visits.

Medicare does not cover a home health aide if that is the ONLY service you need and you are NOT homebound.
It seems many home health agencies don't realize what the
Medicare coverage rules are.

The Center for Medicare Advocacy has a great webinar that goes over Medicare coverage for home health services in great detail.

The best thing of all is Medicare covers these home health services at no cost.

For durable medical equipment and supplies, you pay the Part B deductible and 20% of the covered cost. This is for original Medicare. Medicare Advantage plans may be different.
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Reply to KarenR70
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qureshia110 Oct 17, 2024
Yes, Medicare does cover home health aide services under Original Medicare if you meet specific conditions, as outlined in the 2024 Medicare & You handbook. These services are covered if you're homebound and need skilled care, such as nursing or therapy. It's important to note that Medicare limits the total hours to 28 hours per week (or 35 in certain cases) for skilled nursing and home health aide services combined. However, therapy visits don't count towards this limit.
If a home health aide is the only service you need, and you’re not homebound, then Medicare will not cover it. It's unfortunate that some home health agencies might not fully understand these coverage rules, so it's always helpful to educate yourself. For a deeper dive into these specifics, the Center for Medicare Advocacy offers a helpful webinar. Keep in mind that costs may vary if you're enrolled in a Medicare Advantage plan.
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You can get home health to provide nurse visits(s) and maybe some occupational/physical therapy sessions. Perhaps bathing assistance a couple times a week. Home health visits are very brief and a Dr has to order what they will do.
You are not going to get full or part time hours of care via Medicare, if that's what you're looking for. 24/7 care will come from family members or whatever patient can afford to pay for. If family can't provide the care ..free or paying for it... the next plan would be to figure out what level of facility care she can afford. Perhaps applying for Medicaid to assist with paying for a nursing home.

Sadly, in home care for our elderly is dependent on who in the family will help or how much money is available to hire caregivers. Not much middle ground.

Even hospice, if you use that option will not provide hours per day of care. They do a few things here and there and seem to respond quickly to questions or concerns, but won't do caregiving for and substantial period of time.
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qureshia110 Oct 22, 2024
You’ve raised important points about the limitations of home health care and the challenges families face. It’s true that Medicare typically doesn’t cover 24/7 or even full-time care, which puts the burden on family members or paid caregivers. It’s also helpful to mention Medicaid as a potential option for long-term facility care, especially when families can’t provide the necessary support. Unfortunately, in-home care solutions often come down to balancing personal resources with the care needed, and there’s not much middle ground as you mentioned.
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Actually no but many Medicare supplement plans do. And once you are on hospice usually 100% is covered. Just my experience with my wife.
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Tiajanell1226: https://www.cancer.org/cancer/managing-cancer/finding-care/home-care-agencies/who-pays
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Reply to Llamalover47
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I agree with the answers provided but I would like to suggest something else. This would definitely depend on how advanced the cancer is etc But a lot of people(most) think hospice is only used for the very last few days) weeks of life. This is definitely not the case. at stage 4 Inflammatory breast cancer my mom entered hospice. Anyone can enter hospice (with Dr recommendation) if the normal progression of disease will give person 6 mths or less. However, as we all know people can live longer than that (moms recert for hospice is today- 6 mths mark)so one has to be recertified every 6 mths. But technically can be on hospice indefinitely. Even with a few ups and downs hospice has been very very good for us nurse 3x a WK, cna up to 5 times a WK, social worker,clergy, supplies of any kind. Yes with Medicare. I am primary care giver but hospice has been very helpful. May be worth looking into if your situation warrants it. Best of luck
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As far as I know, just hospice care. I hope someone has a few answers for you. We had to pay for care for my Dad.
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Reply to blondinthesky
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Medicare may cover specific medically necessary visits for therapy or medication following a hospital stay, but it does not cover general at home-care.
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Reply to RedVanAnnie
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I would say if you have supplemental insurance, advantage plan, do check with your doctor, your insurance.

My experience of cancer at age 47 was a different ballgame from cancer now at 81. I am now on Kaiser. WOW! I couldn't get rid of Ma Kaiser for months. I had assigned Social Worker, Nurse Manager, Oncology fellow, radiology followup, surgical followups and YOU NAME IT. Everything got discussed from how to notify of needs to how many steps are in my place, to what future wishes are scanned to chart. I honestly never experienced such thorough care.

So do check out everything. Medicare covers Hospice Care, and I think you may know that. Hospice today sure isn't what it once was and it's pretty rote and by the book, but good access and info, a few baths a week, a social worker, a clergy if wished, an RN once a week and equipment. All paid for by medicare. So not nothing.

Medicaid may have some inhome help and that's dependent on your own state's policies, rules, qualifications.

Good luck on your research for your area. I wish you the very best.
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Reply to AlvaDeer
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"Home health services

Medicare doesn't pay for:

- 24-hour-a-day care at your home
- Meals delivered to your home
- Homemaker services (like shopping and cleaning) that aren’t related to your care plan
- Custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need.

You're not eligible for the home health benefit if you need more than 
part-time or "intermittent" skilled nursing care.

You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care."

Source: https://www.medicare.gov/coverage/home-health-services
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Reply to Geaton777
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I hope this may help you

https://www.cancer.org/cancer/managing-cancer/finding-care/home-care-agencies/who-pays.html
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