What Medicare's home health benefit covers
Part A or Part B covers home health care when your doctor or other provider certifies that you are homebound and need part-time or intermittent skilled care, and a Medicare-certified agency provides it. Covered services include:
- Skilled nursing and physical, occupational or speech therapy.
- Home health aide help with personal care, but only alongside skilled care.
- Medical social services and medical supplies.
You pay $0 for covered home health services. Durable medical equipment has 20% coinsurance.
What Medicare doesn't pay for
- 24-hour care at home.
- Personal care, such as bathing, dressing or using the bathroom, when it is the only care you need.
- Housekeeping, shopping, laundry or meals delivered to your home.
Medicare Advantage plans cover home health care too. Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
Help at home in Oregon
| Program | Who it helps |
|---|---|
| Medicaid in-home services (ODHS) | People who meet income, resource and care-need rules. You can hire an in-home worker directly or use an agency. |
| Oregon Project Independence (OPI) | People 60 and older, or any age with Alzheimer's or a related disorder, who aren't on Medicaid. Limited help with housekeeping, personal care, meals and case management; sliding-scale copay. |
| OPI-M | A Medicaid-funded version for people who qualify, with no cost and no estate recovery. |
| Family caregiver support | Training and support for unpaid family caregivers. |
| PACE | People 55 and older in some counties who need a nursing home level of care but can live safely at home. |
How to get started
- Ask your doctor about home health. If you are homebound and need skilled care, Medicare may cover a period of care.
- Call ODHS Aging and People with Disabilities. The state aging and disability agency (1-855-673-2372) can explain OPI, OPI-M and Medicaid in-home services, and connect you to your local office.
- Apply for Medicaid if you may qualify. Use benefits.oregon.gov or call 1-800-699-9075.
Related questions
Does Medicare cover home health in Oregon?
The skilled home health rules.
What is Oregon Project Independence?
In-home help without Medicaid.
Does Medicare cover memory care in Oregon?
Dementia care and who pays.
Sources
- Medicare.gov — Home health services
- Medicare.gov — Hospice care
- Oregon Department of Human Services — Long-term care
- Oregon Department of Human Services — Oregon Project Independence
- OAR 411-032-0020 — Oregon Project Independence eligibility
More questions in this guide
- Does Medicare cover acupuncture in Oregon?
- Does Medicare cover ambulance service in Oregon?
- Does Medicare cover annual physicals in Oregon?
- Does Medicare cover assisted living in Oregon?
- Does Medicare cover bone density tests in Oregon?
- Does Medicare cover cataract surgery in Oregon?
- Does Medicare cover chiropractic care in Oregon?
- Does Medicare cover a colonoscopy in Oregon?
- Does Medicare cover CPAP machines in Oregon?
- Does Medicare cover dental care in Oregon?
- Does Medicare cover diabetic supplies in Oregon?
- Does Medicare cover flu shots in Oregon?
- Does Medicare cover hearing aids in Oregon?
- Does Medicare cover home health care in Oregon?
- Does Medicare cover mammograms in Oregon?
- Does Medicare cover me when I travel or spend winters outside Oregon?
- Does Medicare cover medical marijuana in Oregon?
- Does Medicare cover memory care in Oregon?
- Does Medicare cover mental health care in Oregon?
- Does Medicare cover naturopathic doctors in Oregon?
- Does Medicare cover nursing home care in Oregon?
- Does Medicare cover oxygen therapy in Oregon?
- Does Medicare cover physical therapy in Oregon?
- Does Medicare cover prostate cancer screening in Oregon?
- Does Medicare cover psilocybin therapy in Oregon?
- Does Medicare cover skilled nursing care in Oregon?
- Does Medicare cover the shingles vaccine in Oregon?
- Does Medicare cover transportation to medical appointments in Oregon?
- Does Medicare cover vision care in Oregon?
- Does Medicare cover wheelchairs in Oregon?
Part of the guide: Learn Medicare — the Oregon starter guide · All questions
Frequently asked questions
Will Medicare pay a home health aide to help with bathing?
Only while you are also getting skilled nursing or therapy under the home health benefit. If personal care is all you need, Medicare doesn't pay for the aide.
Does Medicare pay for respite care so a family caregiver can rest?
Only under hospice. If you are on Medicare hospice, it can cover a short inpatient respite stay of up to five days at a time. Outside hospice, ask ODHS about family caregiver support.
Is Oregon Project Independence only for low-income people?
No. ODHS says the state-funded program has no income or asset limits and charges a copay on a sliding scale. A Medicaid-funded version, OPI-M, has no cost for people who qualify.
Medicare in your Oregon county
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