This page is general education only. SecureElder does not sell, recommend, or enroll anyone in Medicare plans, and nothing here is medical, legal, or financial advice. For questions about your parent's coverage, contact Medicare directly or a free, unbiased counseling program such as Illinois' Senior Health Insurance Program (SHIP).
The short answer
Many families are surprised to learn that Medicare generally does not pay for ongoing help with everyday activities at home. Help with bathing, dressing, meals, housekeeping, companionship, and supervision is called custodial care, and when that is the only help needed, Medicare does not cover it. That is the kind of help most non-medical home care agencies provide.
What Medicare can cover at home
Medicare can cover home health care, which is skilled, medical care in the home, on a part-time or intermittent basis, when certain conditions are met. This often follows a hospital stay, surgery, or a change in health. Generally, a person must:
- Be under the care of a doctor or other qualified provider who certifies the need.
- Need skilled services, such as nursing, physical therapy, or speech therapy.
- Be considered homebound, meaning leaving home takes considerable effort.
- Receive care from a Medicare-certified home health agency.
When those conditions are met, a home health aide may help with personal care as part of the skilled plan, but only while the skilled care continues. Once skilled care ends, the aide help usually ends too.
What Medicare does not cover
- Around-the-clock care at home.
- Custodial or personal care when it is the only care needed.
- Homemaker services like shopping, cleaning, and laundry on their own.
- Meals delivered to the home.
Medicare Advantage plans follow Medicare's rules for home health, and some may offer limited extra in-home support benefits. Benefits differ by plan. Check your parent's plan documents or call the plan directly.
Other ways families pay for home care
Medicaid
Illinois Medicaid programs can help pay for in-home services for people who meet financial and care-need requirements. In Illinois, programs for older adults are coordinated through the Illinois Department on Aging, often through local Care Coordination Units. Eligibility rules are detailed, so contact the state or your local Area Agency on Aging to learn more.
Veterans benefits
Veterans and surviving spouses may be eligible for VA programs that help with in-home care, including certain pension benefits with an added allowance for help with daily activities. The VA or an accredited veterans service officer can explain what may apply.
Long-term care insurance
If your parent bought a long-term care insurance policy, it may help pay for home care. Read the policy for the elimination period (a waiting period before benefits start), the daily or monthly benefit, and whether the policy requires a licensed agency. Call the insurer early, since claims can take time.
Private pay
Most families pay for non-medical home care privately, using savings, income, home equity, or contributions from several family members. Our Naperville home care cost guide shows planning ranges by hours of care.
Putting it together
A common pattern looks like this: after a hospital stay, Medicare covers a few weeks of home health visits from a nurse and therapist. When those visits end, the family realizes their parent still needs help with showers, meals, and getting around, and arranges private non-medical home care for a set number of hours each week. Understanding the difference between home care and home health makes those transitions much less confusing.
To plan a budget, try the care cost calculator. If you would like a licensed local provider to contact you, you can request help.