Is In-Home Care Covered by Medicare or Medicaid?
Posted on December 26, 2025 | Geriatric Resource Centre
By Karen Caponetti, President/CFO
When families begin exploring in-home care, one of the first questions they ask is whether Medicare or Medicaid will help cover the cost. The answer depends on the type of care needed, the individual’s medical condition, and — especially with Medicaid — financial eligibility. Understanding what each program does and does not cover can help you plan more effectively, avoid surprises, and make informed decisions about care at home.
What Is Considered In-Home Care?
“In-home care” is a broad term that can refer to different types of support provided in a person’s home. These generally fall into two categories:
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Home health care – medical services such as skilled nursing, physical therapy, or wound care ordered by a physician.
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Non-medical in-home care – assistance with daily activities like bathing, dressing, meal preparation, mobility support, and companionship.
This distinction is important because Medicare and Medicaid cover these services differently.
Does Medicare Cover In-Home Care?
What Medicare Does Cover
Medicare covers home health care, but only under specific conditions. To qualify, a person typically must:
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Be under a doctor’s care and receive services under a care plan
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Be considered homebound
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Require intermittent skilled nursing care or therapy services
When these criteria are met, Medicare may cover:
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Skilled nursing care (part-time or intermittent)
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Physical, occupational, or speech therapy
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Limited home health aide services when combined with skilled care
These services are usually covered at no out-of-pocket cost under Original Medicare.
What Medicare Does Not Cover
Medicare generally does not pay for:
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Long-term personal care or custodial care
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Full-time or around-the-clock caregivers
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Homemaker services such as cooking, cleaning, or shopping
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Ongoing help with daily activities when no skilled care is required
For families needing consistent, non-medical support at home, Medicare coverage alone is often insufficient.
Does Medicaid Cover In-Home Care?
Medicaid coverage is much broader than Medicare when it comes to in-home care — but eligibility and benefits vary by state.
Medicaid Home and Community-Based Services (HCBS)
Many states offer Home and Community-Based Services (HCBS) waivers, which are designed to help individuals receive care at home instead of in a nursing facility.
Depending on your state and eligibility, Medicaid may cover:
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Personal care assistance (bathing, dressing, grooming)
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Help with daily activities and mobility
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Homemaker services
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Consumer-directed care options
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Limited home health services
To qualify, individuals must typically meet both financial and functional criteria, meaning they need assistance with activities of daily living and fall within Medicaid income and asset limits.
Because programs vary widely, families often need guidance navigating the application process and understanding available benefits.
Medicare vs. Medicaid: Key Differences
| Feature | Medicare | Medicaid |
|---|---|---|
| Based on age/disability | Yes | Yes |
| Based on income/assets | No | Yes |
| Covers skilled home health care | Yes | Yes |
| Covers long-term personal care | No | Often |
| State-specific programs | No | Yes |
What If Medicare or Medicaid Doesn’t Cover Your Needs?
If coverage is limited or unavailable, families may explore other options such as:
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Private-pay in-home care
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Long-term care insurance
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Veterans benefits
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A combination of paid care and family support
Working with an experienced care provider can help you understand your options and design a care plan that fits your situation.
To learn more about available support, visit our In-Home Care Services page.
Frequently Asked Questions
Does Medicare pay for 24-hour in-home care?
No. Medicare does not cover round-the-clock or full-time in-home care. It only covers part-time skilled services under specific medical conditions.
Will Medicaid pay for a caregiver to come to my home?
In many states, yes. Medicaid may cover in-home caregivers through Home and Community-Based Services programs if you meet eligibility requirements.
Can Medicare and Medicaid be used together for in-home care?
Yes. Some individuals qualify for both programs. In those cases, Medicare may cover skilled care while Medicaid helps pay for long-term personal care.
Is companionship or help with daily activities covered?
Medicare does not cover companionship or daily living assistance alone. Medicaid may cover these services depending on your state’s program.
How do I know if I qualify for Medicaid in-home care?
Eligibility depends on income, assets, medical need, and state-specific rules. Speaking with a care coordinator or elder care professional can help clarify your options.
Conclusion
While Medicare offers limited coverage for skilled home health care, it does not pay for long-term personal caregiving. Medicaid, on the other hand, often provides more comprehensive in-home support for those who qualify — though benefits vary by state.
Understanding these differences can help families plan more confidently and make informed decisions about aging at home.
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Need Help Understanding Your In-Home Care Options?
Navigating Medicare, Medicaid, and in-home care coverage can feel overwhelming — especially when you’re trying to make the best decision for a loved one. Geriatric Resource Centre can help you understand your options and plan the right level of care with confidence.