Does Medicare pay for home care in Delaware?
Short answer
Mostly no. Medicare pays for home health: part-time nursing or therapy that a doctor orders for someone who is homebound. A home health aide can help with bathing only while that skilled care is going on. Medicare doesn't pay for ongoing help with bathing, meals, and company when that's the only care needed. In Delaware, that kind of care is paid privately or by Medicaid long-term care.
Last updated · Reviewed by Reliable Aid care team
It's one of the first questions families ask: "Mom has Medicare. Won't it pay for someone to help her at home?" The honest answer is that Medicare pays for some care at home, but usually not the kind most families are looking for.
What home care does Medicare cover?
Medicare covers home health, which is medical care at home. A doctor must order it, the person must be homebound, and they must need part-time skilled nursing or therapy. A Medicare-certified home health agency provides it. While that skilled care is going on, a home health aide can also help with bathing and dressing.
To qualify, Medicare.gov says the person must:
- Be under a doctor's care, with a plan of care the doctor reviews
- Need part-time skilled nursing, physical therapy, speech therapy, or continued occupational therapy
- Be homebound
- Have a face-to-face visit with a doctor or other provider related to the reason for care
- Get care from a Medicare-certified home health agency
Aide visits are limited. Medicare.gov describes part-time care as up to 8 hours a day combined, and up to 28 hours a week.
What does "homebound" mean?
Homebound means leaving home takes a lot of effort. Medicare treats someone as homebound when they need help, a device, or special transportation to leave, or a doctor advises against it, and they normally can't leave. Medical visits and short, occasional outings, like religious services or a trip to the barber, don't change that. Neither does going to adult day care.
What doesn't Medicare pay for?
Medicare doesn't pay for everyday help at home when that's the only care someone needs. Medicare.gov lists these as not covered:
- 24-hour care at home
- Meals delivered to the home
- Shopping, cleaning, and laundry, when they aren't part of the care plan
- Personal care, like bathing, dressing, and using the bathroom, when that's the only care needed
Those are the things families most often need help with. They're what a personal care or companion care caregiver does.
Does Medicare pay family caregivers?
Medicare doesn't have a benefit that pays a family member to care for a parent or spouse. Medicare home health pays certified agencies for skilled care.
In Delaware, the usual way to get paid for caring for a loved one is through Medicaid long-term care. When your loved one qualifies, you can work for Reliable Aid as their paid caregiver. See how paid family caregiving works.
What about Medicare Advantage?
Some Medicare Advantage plans offer extra benefits, and CMS allows certain plans to include in-home support for some members with chronic illness. These extras vary a lot from plan to plan and year to year. If your parent has a Medicare Advantage plan, call the number on their card and ask whether it includes any in-home support.
What if your parent has both Medicare and Delaware Medicaid?
When someone has both, Medicare pays first for medical care, like doctors, hospitals, and home health. Medicaid can cover long-term services that Medicare doesn't, including personal care at home. In Delaware, that's Medicaid's long-term care program, Diamond State Health Plan Plus.
A regular Medicaid card isn't enough by itself. Your parent needs to qualify for long-term care. See how Medicaid home care works in Delaware.
Who pays for what in Delaware
| Type of care | Medicare | Delaware Medicaid long-term care | Private pay |
|---|---|---|---|
| Skilled nursing or therapy at home | Yes, when the rules above are met | Can help, for people who qualify | Yes |
| Bathing, dressing, and meals with no skilled care | No | Yes, for people who qualify | Yes |
| Companionship and supervision | No | Can be part of an approved care plan | Yes |
| 24-hour care at home | No | Depends on the hours the plan approves | Yes |
| Paying a family caregiver | No | Yes, through an agency like ours | Not applicable |
When home health and home care work together
After a hospital stay, Medicare home health might send a nurse or therapist a few times a week. Between those visits, someone still has to help with showers, meals, and getting around. That's where home care fits. See home care after a hospital stay, or read home care vs. home health for the full difference.
How Reliable Aid helps
We help with the everyday care Medicare doesn't pay for: bathing, dressing, meals, getting around, and company. We work with private-pay families and with Delaware Medicaid long-term care. If your parent might qualify for Medicaid, we'll walk you through the steps.
Call (302) 689-3240. The first conversation is free. Or visit our Dover office.
Questions
Will Medicare pay me to take care of my mom?
Medicare doesn't have a benefit that pays family members for everyday care. In Delaware, the usual way to get paid for that care is Medicaid long-term care, when your parent qualifies.
Does Medicare pay for 24-hour care at home?
No. Medicare.gov lists 24-hour care at home as something Medicare doesn't cover.
Does Medicare pay for respite care?
Only inside hospice. Someone on Medicare hospice can have a short stay in a facility so the family caregiver can rest. Respite care at home outside hospice isn't a Medicare benefit.
How much does Medicare home health cost?
Medicare.gov says you pay nothing for covered home health services. Medical equipment, like a walker, is billed separately under Part B.