What Medicare Does — and Does NOT Do — for Aging at Home
What it is
The single most expensive misunderstanding in aging: families assume Medicare will pay for ongoing help at home or for assisted living. It won't. Medicare's own long-term-care page says it directly: for ongoing "custodial" care — help with bathing, dressing, eating, supervision — "You pay all costs."
What Medicare DOES cover (Original Medicare)
- Home health after illness or injury — part-time skilled nursing or therapy at home when a doctor certifies you need it and you're homebound. $0 for covered services. Unlimited visits while you qualify — but it's skilled, part-time care, not a daily aide.
- Equipment (DME — durable medical equipment) — walkers, wheelchairs, hospital beds, oxygen, commode chairs, when a doctor orders them. You pay 20% after the Part B deductible. Ask any supplier first: "Do you accept Medicare assignment?"
- Hospice — for terminal illness, $0 comfort care at home or where you live, from a Medicare-approved hospice; small drug copays; room & board not included.
What it does NOT cover
24-hour care at home · a daily personal-care aide as the only need · home-delivered meals · homemaker services · assisted-living or nursing-home custodial stays.
So who pays for long-term care?
For people with limited means: Medi-Cal — IHSS, PACE, ALW, MSSP. That's why the Medi-Cal pages matter even for people who "have Medicare."
Medicare Advantage note
Some Advantage plans add extras like rides or in-home support. Whether YOURS does depends entirely on the plan — call the number on the plan card, or have HICAP check for free: (800) 434-0222. We never recommend plans; HICAP's free counselors exist exactly for that.
How to start
Ask the doctor for a home-health or hospice referral when the need arises; agency search at medicare.gov Care Compare.
Official sources
We describe programs; we don't make medical, legal, or insurance decisions for you. For Medicare choices, HICAP counselors advise you free: (800) 434-0222. For anything medical, talk with the doctor.