Updated October 2026. Reviewed by the clinical team at Choice Care Home Health.
Yes. Original Medicare covers home health care in Illinois when you are homebound, need skilled nursing or therapy, are under a doctor’s plan of care, and use a Medicare-certified agency. Medicare does not cover 24-hour care, live-in care, or help with chores when that is the only care you need.
That short answer hides a few rules that families often miss. This guide explains what Medicare home health covers, what it leaves out, who qualifies, what you pay, and how Medicare Advantage changes the picture. It is written by the team at Choice Care Home Health, a Medicare-certified and ACHC-accredited agency in Orland Park that has served patients since 2001.
A home health nurse reviews the plan of care with a patient at home.
Medicare Home Health at a Glance
| Usually covered (if you qualify) | Usually not covered |
| Part-time skilled nursing | 24-hour care at home |
| Physical therapy | Live-in caregivers |
| Speech-language pathology | Cleaning, laundry and shopping |
| Occupational therapy (added to a qualifying plan, or continued after other services end) | Meal delivery |
| Home health aide visits, only with skilled care | Personal care or aide help when it is the only care you need |
| Medical social services | |
| Medical supplies and covered equipment |
What Medicare Home Health Covers
Medicare pays for these services when they are ordered in your plan of care and delivered by a Medicare-certified agency.
Skilled Nursing Care
Medicare may cover skilled nursing when it is part-time or intermittent. In Medicare’s terms, that means fewer than 7 days a week, or less than 8 hours a day for up to 21 days (with some limited extensions). A registered nurse or licensed practical nurse can give wound care, injections, medication teaching, monitoring of a new or changing condition, and care after a hospital stay.
Physical Therapy at Home
Medicare may cover physical therapy at home when a doctor certifies that you need it and it is part of your plan of care. Typical goals include walking, balance, strength, and stairs after surgery, a fall or an illness. Therapy can also be covered to help you keep your abilities or slow a decline, not only to improve. You do not have to show steady progress to qualify, but the care must still be skilled and needed.
If you are unsure how physical therapy differs from occupational therapy, read our guide to physical therapy vs occupational therapy at home.
Occupational Therapy and Speech-Language Pathology
Occupational therapy helps with daily tasks such as dressing, bathing, and cooking. Under Medicare’s current rules, occupational therapy alone cannot make you eligible for home health. It can be added once you qualify through nursing, physical therapy, or speech-language pathology, and it can continue after those services end. Rules can change, so confirm the latest on Medicare.gov. Speech-language pathology can help with swallowing, speech, and language problems after a stroke or illness.
Home Health Aide Services
This is the part people ask about most. Medicare may cover part-time home health aide visits for personal care, such as help with bathing, dressing, and using the bathroom. The key rule: aide visits are covered only while you are also getting skilled nursing or therapy. If an aide is the only help you need, Original Medicare does not pay for it. For the full steps, see how to get a home health aide with Medicare, and for the difference between the two roles, see skilled nursing vs home health aide.
Aide visits are covered only when you also receive skilled care.
Medical Social Services
A medical social worker can help your family find community resources, plan for long-term needs and cope with the stress of an illness. Like aide services, this is covered when you also receive a qualifying skilled service.
Medical Supplies and Equipment
Medicare covers medical supplies ordered in your plan of care. It also covers durable medical equipment (DME) such as walkers, wheelchairs, hospital beds and oxygen equipment. Equipment is billed separately from the home health benefit, which affects what you pay (see the cost section below).
What Medicare Does Not Cover
Original Medicare home health does not pay for:
- 24-hour care at home
- Live-in caregivers
- Homemaker help such as cleaning, laundry and shopping, when it is the only care you need
- Meal delivery
- Personal care or custodial care, such as help with bathing or dressing, when it is the only care you need
If you need this kind of help, read about how to pay for home health care without Medicare.
Does Medicare Cover In-Home Care?
“Home care” and “home health care” sound the same, but Medicare treats them very differently. Home health care is skilled, medical care ordered by a doctor, and Medicare may cover it. In-home care (also called personal care or custodial care) is non-medical help with daily living, companionship and household tasks. Original Medicare usually does not cover it on its own. For families dealing with memory loss, our guide on Medicare and in-home care for dementia goes into more detail.
Who Qualifies for Medicare Home Health Care?
You usually need to meet all of these requirements:
- You have Medicare Part A and/or Part B.
- You are under the care of a doctor (or an allowed provider) who creates and reviews a plan of care.
- You need skilled care: intermittent skilled nursing, physical therapy, or speech-language pathology. Occupational therapy can continue after these end.
- You are homebound. Leaving home takes a major effort, and absences are short or infrequent, such as medical visits or religious services.
- You had a face-to-face visit with your doctor or an allowed provider related to the reason you need home health, within 90 days before or 30 days after you start care. This visit can be done by telehealth.
- A Medicare-certified agency provides the care.
For a step-by-step walkthrough, see how to qualify for Medicare home health care in Illinois.
The required face-to-face visit can sometimes be done by telehealth.
How Much Does Medicare Home Health Care Cost?
For covered home health services, you usually pay $0. For durable medical equipment, you typically pay 20% of the Medicare-approved amount, and the Part B deductible may apply. You pay the full cost of anything Medicare does not cover.
Your agency should tell you in writing before it provides a service that Medicare may not pay for, so you can decide whether to continue. Ask which notice applies to you. For a broader look at private-pay prices, see home health care cost in Illinois.
Does Medicare Advantage Cover Home Health Care?
Yes. Medicare Advantage (Part C) plans must cover everything Original Medicare covers, including home health. The difference is how you get it. Many plans require prior approval, a referral, or an agency that is in the plan’s network, and some offer extra benefits. Costs and rules vary by plan.
Check your plan’s approval and network rules before care starts.
Before starting care, call your plan and confirm which agencies are in network. You can also read how specific plans work in our guides to Humana Medicare Advantage home health coverage and WellCare home health coverage in Illinois, or see the insurance plans we work with.
How Do You Pay for Care Medicare Does Not Cover?
Many Illinois families use a mix of options: Medicaid programs for people who qualify, long-term care insurance, veterans’ benefits, Medicare Advantage extras, and private pay. Eligibility and benefits differ for each, so ask each program what it covers before you start. Our guide on paying for home health care without Medicare walks through the options.
How to Choose a Medicare-Certified Agency
Medicare pays only for care from a Medicare-certified agency. Medicare certification and ACHC accreditation are two different things: certification lets an agency bill Medicare, while accreditation shows it has passed an outside review of its standards. Choice Care Home Health holds both. You can compare agencies near you on Medicare’s Care Compare tool. Good questions to ask:
- Are you Medicare-certified in Illinois?
- Do you work with my Medicare Advantage plan?
- How soon can you start care after my doctor’s order?
- Who will be my point of contact if I have a question?
Medicare Home Health Care in Orland Park, Palos Heights, Oak Lawn and Will County
Choice Care Home Health is based at 15635 S 94th Ave, Orland Park, IL 60462, and serves families across the southwest suburbs. Find local information on our pages for Orland Park, Palos Heights, Oak Lawn, and Will County.
Frequently Asked Questions
Does Medicare pay for a home health aide?
Only in certain cases. Medicare may cover part-time home health aide visits for personal care, such as bathing and dressing, when you also receive skilled nursing or therapy under a doctor’s plan of care. If an aide is the only care you need, Original Medicare does not cover it.
Does Medicare cover physical therapy at home?
Yes, it can. Medicare may cover physical therapy at home when you are homebound, a doctor certifies that you need it, and a Medicare-certified agency provides it. The therapy must be skilled and reasonable for your condition, and it is part of a written plan of care.
What does homebound mean for Medicare?
Homebound means leaving home takes a major effort, for example because you need a walker, wheelchair or another person’s help, or because leaving is not advised for your condition. You can still go to medical visits, religious services and short, infrequent outings.
Does Medicare cover live-in or 24-hour home care?
No. Original Medicare does not cover 24-hour care at home or live-in caregivers. It covers part-time or intermittent skilled home health care. Families who need round-the-clock help usually pay privately, use long-term care insurance or look at Medicaid programs if they qualify.
Does Medicare pay for cleaning or help around the house?
No. Original Medicare does not pay for homemaker help such as cleaning, laundry, shopping or meal delivery when that is the only help you need. These tasks may be covered by some Medicaid programs, long-term care insurance or paid privately.
Does Medicare Advantage cover home health care?
Yes. Medicare Advantage plans must cover the home health care that Original Medicare covers. They may add rules, such as prior approval or using an in-network agency, and some offer extra benefits. Check your plan before starting care, or call us and we can help you understand the steps.
Does Medicare pay for home health care by the hour?
No. You do not pay Medicare an hourly rate. For covered home health services you usually pay $0, and Medicare pays the agency under its own payment rules. Hourly rates apply to private caregivers, which Original Medicare does not cover.
Is there a time limit on Medicare home health care?
There is no fixed lifetime limit as long as you still qualify. Your doctor reviews and renews your plan of care at least every 60 days. Care continues while you remain homebound, still need skilled care and meet Medicare’s rules.
What insurance covers in-home care in Illinois?
Original Medicare covers only skilled home health care. Other options can include Medicare Advantage plans, Medicaid programs for people who qualify, long-term care insurance, veterans’ benefits and private pay. Coverage varies by plan, so confirm details with your insurer.
Key Takeaways
- Medicare covers part-time skilled home health care when you are homebound, have a doctor’s plan of care and use a certified agency.
- Aides, social work and occupational therapy are covered only alongside a qualifying skilled service, with the OT rules described above.
- Medicare does not cover 24-hour care, live-in care, or cleaning and chores when that is the only help you need.
- You usually pay $0 for covered home health services and 20% for equipment.
- Medicare Advantage plans cover the same care but may add approval and network rules.
Take the Next Step with Choice Care
Not sure whether you or a loved one qualifies? Call Choice Care Home Health at (708) 489-0123 or contact us and we will talk through your situation. Whether you qualify depends on your doctor’s orders and your health needs, so we cannot promise coverage, but we can explain the steps and what to expect.
This article is for general information and is not medical, legal or insurance advice. Medicare rules can change. Check current details at Medicare.gov or with your doctor or plan.