The Medicare home health benefit should be an important lifeline for people in need of care to live safely and healthily at home. Under the law, people who meet Medicare qualifying criteria can receive covered home care on an on-going basis, with no co-pay. Coverable care includes nursing, therapies, home health aides, and other services. This is the law.
Regrettably, however, people who meet the legal Medicare coverage criteria continue to face access barriers to covered home health. Access problems escalate as impediments to providing legally covered services increase. Many of the barriers are the result of Medicare’s payment system, quality measures, and audits that lead home health agencies to resist providing care for people with longer-term and chronic conditions and for home health aides.
The Center for Medicare Advocacy is alarmed about the demise of the Medicare home health benefit and the growing inequities in access to necessary home care. Often, people who can obtain Medicare-covered home care often can do so only for short periods of time and only for nursing, physical and/or occupational therapy. Longer periods of care, and any home health aide services, are only available if there is another payment source besides Medicare – be it private pay, other insurance, or Medicaid.
The Center responds to numerous beneficiaries seeking access to home health care. We provide education materials and presentations for the community and advocates, speak with journalists highlighting barriers to home health care, and reply to policy-makers concerned about this growing problem. In August 2025, we commented on CMS’ proposed Medicare home health payment rule. Please visit the Center’s website, MedicareAdvocacy.org, to review community-oriented and analytical materials about Medicare home health coverage. Click here for an infographic regarding Medicare home care.
October 23, 2025 – J. Stein