Caregiver Support14 mins
Home health guide
Home health care, explained.
Medicare pays for skilled care at home for people who are homebound and need it. Here is what home health covers, who qualifies, what it costs, how CMS rates agencies and what to ask before you choose one.
- Medicare-certified home health agencies in CMS’s files
- 12,646
- have a CMS quality of patient care star rating
- 64%
- average star rating among rated agencies
- 3.2
- what Medicare patients pay for covered home health services
- $0
CMS home health agency file, loaded September 2026. Medicare charges 20% for medical equipment.
01The difference
Home health vs. home care
They sound alike, but they are different services with different rules. Home health is medical care that Medicare can pay for; home care is help with daily life that it generally doesn't.
| Home health care | Home care | |
|---|---|---|
| What it is | Skilled medical care at home while you recover or manage an illness | Help with daily life: bathing, dressing, meals, housekeeping, company |
| Who provides it | Nurses, therapists, medical social workers and aides from a certified agency | Caregivers and aides, often from a private home care agency |
| How it starts | A doctor or allowed practitioner orders it and signs a plan of care | You arrange it yourself |
| Does Medicare pay? | Yes, when you qualify | No, unless it is part of covered home health care |
What agencies offer
Medicare requires every certified agency to offer skilled nursing and at least one other service: therapy, medical social work or home health aide care.9 Most offer much more, but services vary, so check an agency's profile before you call.
02Who qualifies
Who qualifies for Medicare home health
You need to meet all four conditions. If you have a Medicare Advantage plan, it covers home health too but may require approval and use a network.
- You’re homebound. Leaving home isn’t recommended because of your condition, or you can’t leave without help, and leaving normally takes a lot of effort. You can still go out for medical care, religious services or adult day care, and for short, infrequent outings.
- A clinician orders it. A doctor, nurse practitioner, clinical nurse specialist or physician assistant sees you in person or by telehealth, within 90 days before or 30 days after care starts, orders your care and signs a plan of care.
- You need part-time skilled care. Intermittent skilled nursing, or physical therapy, speech-language pathology or continuing occupational therapy.
- The agency is Medicare-certified. Every agency in our home health search is certified by Medicare.
What Medicare doesn't cover at home
- Care around the clock at home
- Meal delivery
- Shopping, cleaning and other homemaker services unrelated to your care plan
- Personal care, such as bathing and dressing, when it is the only care you need
03Costs
What home health costs
With Medicare, usually nothing for the care itself. The costs to plan for are equipment and any help beyond what Medicare covers.
- Medicare
$0 for covered services
No deductible or copay for covered home health care. Medical equipment, such as a walker or hospital bed, costs 20% of the Medicare-approved amount after the Part B deductible.1
- Medicaid
Covered for people who qualify
States must cover home health for adults who qualify for Medicaid nursing facility care, without a homebound rule. Many also pay for personal care through waiver programs.4
- Medicare Advantage
Covered, with plan rules
Plans must cover home health but can require approval first, use networks and set their own cost sharing. Check with the plan.
- Paying yourself
Help beyond Medicare
In 2025 the national median was $35 an hour for an in-home caregiver and $160 a visit ($90 an hour) for a private-duty nurse. Prices vary widely by region.7
04Star ratings
How CMS rates home health agencies
CMS publishes two star ratings for agencies and updates them every quarter. Our profiles show the quality of patient care rating.
The quality of patient care rating runs from 1 to 5 stars in half-star steps and compares agencies on seven measures from patient assessments and Medicare claims:3
- Timely initiation of care
- Improvement in walking or moving around
- Improvement in getting in and out of bed
- Improvement in bathing
- Improvement in shortness of breath
- Improvement in taking medicines by mouth correctly
- Potentially preventable hospital stays during care
CMS also publishes a separate patient survey rating from a national survey of patients about their care; you can see it on Medicare's Care Compare.
4,505 agencies (36%) have no quality rating. CMS rates an agency only when it has data for at least 5 of the 7 measures, so a new or small agency may simply not be rated yet.
05Choosing an agency
Questions to ask a home health agency
The star rating narrows the list. These questions tell you what care will be like day to day.
How soon can you start?
CMS measures how quickly agencies begin care after a referral or discharge. Ask for a date and time for the first visit.
Who will come, and will it be the same person?
Continuity makes it easier to notice small changes. Ask who your nurse or therapist will be and how often visits happen.
How do I reach a nurse at night or on a weekend?
Federal rules don’t require home health agencies to staff a 24-hour line, so ask exactly who answers after hours and whether a nurse can visit.
Do you have staff experienced with my condition?
Recovery after heart surgery, wound care and stroke rehab need different skills. Ask who on the team has done it before.
How often do your patients end up back in the hospital?
Potentially preventable hospital stays are part of the CMS star rating. Ask how the agency tries to prevent them.
What happens when Medicare coverage ends?
The agency must give you a Notice of Medicare Non-Coverage at least 2 days before covered care ends, and you can ask for a fast appeal.
On the 24-hour line: CMS's 2017 rule.5 On appeals: Medicare.gov.6
06FAQ
Questions families ask
What is the difference between home health care and home care?
Home health care is skilled medical care, such as nursing or therapy, ordered by a clinician and delivered by a certified agency; Medicare pays for it when you qualify. Home care is non-medical help with daily life, such as bathing, meals and housekeeping, which Medicare generally does not pay for.
How much home health care will Medicare cover?
Skilled nursing and home health aide time together, in most cases up to 8 hours a day and 28 hours a week, as long as you remain homebound and need skilled care. Your plan of care is reviewed and recertified regularly.
Does Medicare pay for someone to be with me all day?
No. Medicare does not cover 24-hour care at home, homemaker services or personal care when it is the only care you need. Medicaid, long-term care insurance or private pay may cover some of it.
Why doesn’t an agency have a star rating?
CMS rates an agency only when it has enough data, from at least 5 of the 7 measures in the rating. A new or small agency may not be rated yet, which says nothing about the quality of its care.
Can I choose my home health agency?
Yes. With Traditional Medicare you can use any Medicare-certified agency that serves your area and accepts you, and a hospital discharging you must give you a list of options. Medicare Advantage plans may limit you to their network.
Does Medicaid pay for home health?
Yes, for people who qualify. States must cover home health for adults who qualify for Medicaid nursing facility care, and Medicaid cannot require you to be homebound. Many states also pay for personal care and other help at home through waiver programs.
07Sources
Where this guide comes from
Every rule and figure on this page, with a link to the original.
Written by the Care Ratings Team and reviewed by the TCR Editorial Team. Last reviewed . How our data works: methodology.
This guide is general information, not medical, legal or financial advice. Coverage rules change; check Medicare.gov or call 1‑800‑MEDICARE (1‑800‑633‑4227) about your own situation.
Next step
Find home health agencies near you.
Compare CMS star ratings, services and member reviews for Medicare-certified agencies that serve your area.
