Medicare coverage depends on the service, your eligibility and the provider's certification—not simply the name of a home-care company. If you are considering Visiting Angels, Comfort Keepers or another agency, ask the local office exactly what it provides and how it bills.
Separate two different types of care
| Service requested | What to verify |
|---|---|
| Companionship, shopping or personal assistance alone | Generally outside Medicare's home health benefit. |
| Skilled nursing or qualifying therapy at home | Requires the home health eligibility and provider rules. |
| Aide assistance alongside covered skilled services | Must be included in the qualifying care arrangement. |
Questions for a named agency
- What is the exact legal name of the local provider?
- Is it a Medicare-certified home health agency?
- Which requested services are medical, and which are private-pay assistance?
- Will it accept your coverage and give a written cost estimate?
A familiar brand, a caregiver's credentials or an office's statement that it helps seniors does not answer all these questions. Do not assume every office offers identical services.
Home health has eligibility requirements
Your practitioner must evaluate and order qualifying care. You generally need intermittent skilled services and must meet Medicare's homebound requirements. The benefit does not provide permanent, around-the-clock personal staffing. Covered home health services and equipment can also have different cost rules.
If the requested help is not covered
Ask your state Medicaid agency about home and community services and their eligibility requirements. PACE may be an option in participating areas for people who meet its specific criteria. Local aging-service programs may also have information about caregiver support.
Before signing a private-care agreement, identify the hourly or visit rate, minimum commitment, cancellation terms and who pays. A Medicare Advantage member should separately confirm any plan-specific support benefit; do not rely on another person's plan or an old advertisement.
Related coverage questions
- Medicare Home Health Care: Services, Eligibility and Costs
- Medicare Respite Care: The Hospice Benefit and Its Limits
- Nursing Home Care and Medicare: Understand the Difference