Is In-Home Health Care for Seniors Covered by Insurance?

As aging parents or loved ones begin to need more assistance at home, many families consider in-home health care for seniors as an option. However, an important and common question arises: Is it covered by insurance? The answer usually depends upon the type of care needed, together with the type of coverage available, primarily Medicare.

Understanding the basics of what’s covered can help you prepare for the road ahead with less financial uncertainty and more peace of mind.

About Medicare and In-Home Care

Medicare is federal health insurance given mainly to citizens who are 65 years or older. The program allows benefits for a few medical services, including short-term care at home under a set of conditions.

Medicare Part A and Part B may cover in-home health care for elderly individuals.

Medicare Part A – Hospital Insurance

• Covers inpatient hospital care

• Includes skilled nursing facility care

• Provides coverage for hospice care

• Covers home health care (The patient should be homebound- unable to leave home without considerable effort or assistance)

  
  

Medicare Part B – Medical Insurance

• Covers doctor visits and outpatient care

• Includes lab tests, preventive screenings, and vaccinations

• Covers home health care services (when medically necessary)

• Includes durable medical equipment (DME)

• Pays for doctor services during hospital stays

• Covers outpatient mental health care

• Includes preventive services like:

1. Cardiac rehabilitation

2. Mammograms

3. Cardiovascular and diabetes screenings

4. Flu shots and more

What Medicare Covers and What It Doesn’t

It’s important to separate skilled care (which may be covered) from custodial care (which usually isn’t).

Medicare May Cover:  

• Skilled nursing care (part-time/intermittent)

• Physical, speech, or occupational therapy

• Medical social services

• Home health aide (if the patient is also receiving skilled services)

• Medical equipment like walkers or wheelchairs

 

Medicare Does Not Cover:

• 24/7 home care

• Personal care only (bathing, dressing, grooming, unless tied to skilled services)

• Meal delivery or grocery shopping

• Housekeeping or laundry services

• Long-term non-medical care

 

How In-Home Health Care Providers Can Help

Working with professional in-home health care providers can make navigating insurance much easier. Experienced providers help families:

• Understand what’s covered and what isn’t

• Coordinate with doctors to create and submit care plans

• Connect with Medicare-approved agencies

• Explore alternative funding options for uncovered services.

This kind of support ensures that seniors receive consistent care without unnecessary stress for the family.

Conclusion

While in-home health care for seniors can be partially paid by Medicare, you should be aware of its limitations. Mostly, the coverage is granted on a short-term basis or only when medically necessary, but it does not cover long-term personal care.

Senior care can sometimes be confusing. At A Plus Care LA, our experienced team works with you to find the right balance of services, care plans, and insurance support—ensuring your loved one receives the quality care they deserve, in the comfort of home.