How to Qualify for Medicare Home Care

Art: Robin Mead

Medicare may provide assistance in your home, including physical therapists, occupational therapists, speech therapists, nursing, and home aide services. On this page you will find:

Option One: Start by Looking into Medicaid

If your goal is home aides (help with bathing, dressing, eating, shopping, cooking, cleaning, etc) start by looking into Medicaid, not Medicare. So far, 100% of our readers report that this is the better program for home aides: How To Apply for a Medicaid Home Aide

Option Two: If You Have Too Much Money for Medicaid

Many people on Medicare assume (wrongly) that they won’t be eligible for the Medicaid home aide services. Don’t give up hope without looking into it. Even people with too much money for Medicaid, sometimes are able to till qualify for the Medicaid home aide programs. Here is what to do When You Have Too Much Money for Medicaid Home Aides

Option Three: Medicare Home Visits from Doctors and Practitioners  

In some areas, doctors, nurses, physical therapists, and other practitioners will come do home visits in your house. Medicare pays for this service. This is a great service, because it’s easy! You don’t have to apply for it! If it is available in your area, all you do is call and schedule an appointment. Learn more about where to find doctors that provide this service: How to Get a Doctor to Come to Your House

Option Four: Medicare Home Health

Medicare Home Health is a program you apply for and enroll in. Once you are in the program, you can get visits from a nurse, Social Worker, home aide and/or physical therapist. It is run through home care agencies. Here is who qualifies for Medicare Home Health:

🌷 One: You must be homebound. Medicare definition of “homebound”. You do not need to be in your home 100% of the time: You need the help of another person or special equipment (walker, wheelchair, crutches) to leave your home or your doctor believes that leaving your home would be harmful to your health. And it is difficult for you to leave your home and you typically cannot do so.

🌷 Two: You must need skilled care. You need intermittent skilled care (somewhere between once a day and once every sixty days). Skilled nursing care or skilled physical or speech therapy.

🌷 Three: Your doctor signs a home health certification. You need a face-to-face visit with a doctor to get this filled out. In some cases, this can be done by video conference. A Medicare Home Care Agency should be able to give you this form or help you make arrangements to meet with a doctor.

Once you are in the program, you may be eligible for:

🌷 Skilled nursing services up to 28 hours per week. (35 hours in unusual cases). Examples of services: injections, tube feedings, catheter changes, and wound care.

🌷 Home health aide for personal care (services may be very limited).

🌷 Physical, speech and occupational therapy services

🌷 Medical Social Work. Talk to a Social Worker.

How to apply:

🌷 Azalea was shared some great tips on exactly what she did to qualify: How I Got Physical, Speech and Occupational Therapy at Home

🌷 Learn More About Medicare Home Care

🌷 Find a Medicare Home Care Agency

🌷 Medicare policy on qualifying for home care

Juniper’s story

“I was on Medicare Home Health. They provided me with a home aide 1 hour per week. They sent someone from an agency to help me take a bath. After 6 months, they stopped sending anyone.

“Then I switched to the Medicaid program. Now I get 31 hours per week for my home aides and they don’t send someone from an agency. I can choose who I want to be my aide, so I chose my sister. She helps me with bathing, dressing, shopping, cooking, cleaning, and driving me to doctors, and she is paid through the state.”

Option Five: More Options

Other programs that provide home aides and home services: How to Get a Caregiver


Small warning: If you have ME or CFS, physical and occupational therapy should be done by someone knowledgable about your condition. Learn more about this.

Some people are told that Medicare home care is only available short term. This is not true and you can appeal this decision. Medicaid home care is ongoing and our readers have not reported any problems with length of time.

What Do You Think? 

Please comment below with stories, ideas, questions or suggestions. Please let us know if any links on this page stop working.

Updated January 2019. If you found this page helpful, please share it with others by pressing one of these magic little buttons:

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