Medicare may cover home health services if a person qualifies, meaning a doctor has certified that they are homebound and need part-time or intermittent skilled nursing care or therapy delivered by a Medicare-certified home health agency. Medicare usually does not pay for ongoing non-medical home care when help with daily activities is the only need. Twenty-four-hour care at home, homemaker services on their own, meal delivery, and custodial or personal care without a qualifying skilled service are not covered. For families in Chesapeake, Richmond, and across Virginia, that single distinction explains most of the confusion, and most of the disappointment, in the first week of trying to arrange help.

Two Different Services with the Same Nickname

People say “home care” and “home health” interchangeably. Hospital discharge planners sometimes do too. They are not the same.

Skilled home health is clinical. A physician orders it. A nurse or a physical, occupational, or speech therapist delivers it. It is intermittent and short-term, organized around a plan of care that has to be reviewed and recertified. Its purpose is to treat or manage a condition.

Non-medical home care is help with daily life. Bathing, dressing, grooming, toileting, transfers, meals, light housekeeping, medication reminders, companionship, supervision, transportation. No physician order is required. It continues for as long as the family wants support. Its purpose is to make it possible for someone to keep living at home.

Medicare was designed around the first one.

What Medicare Covers When it Does Cover

When the eligibility rules are met, the covered home health benefit can include skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social services, certain medical supplies, and part-time home health aide visits, though aide visits are covered only alongside a qualifying skilled service. Covered home health services carry no copayment or coinsurance.

The homebound requirement is less restrictive than it sounds. It does not mean never leaving the house. It means leaving home takes a considerable effort, or requires help from another person or a device. Medical appointments and occasional outings do not disqualify someone.

What it is not is long-term support. The benefit runs in finite certification periods that a doctor renews if the skilled need continues. When the skilled need ends, the benefit ends, even though the need for help with bathing and meals usually does not.

The Gap Families Hit After a Hospital Stay

This is the moment we get most of our calls. A parent comes home from a hospital in Norfolk or Henrico, home health is arranged, and a nurse visits twice a week. Everyone relaxes. Then the family realizes the nurse is there for forty minutes and nobody is there for the other one hundred and sixty hours, including at 6am when getting out of the shower is the actual danger.

Skilled home health and non-medical home care are not competitors. They run at the same time, and they work well together. One treats the condition. The other keeps the household functioning.

What About Medicare Advantage?

Some Medicare Advantage plans have added limited in-home supportive benefits, and these vary considerably by plan and by year. If your parent is on an Advantage plan, call the plan directly and ask specifically about in-home personal care hours or caregiver support benefits. Do not assume, in either direction. 

So Who Does Pay?

For non-medical home care in Virginia, most families use private pay, often combined with something else. Long-term care insurance may help depending on the policy. Veterans benefits may help eligible veterans and surviving spouses. An approved workers’ compensation claim may pay for in-home attendant care when the need followed a workplace injury. Medicaid or Virginia’s CCC Plus Waiver may help some people who qualify, with eligibility beginning at a long-term services and supports screening through the local Department of Social Services. Program availability, eligibility, and benefit limits apply. Confirm coverage directly with the appropriate program, insurer, or benefits representative.

The Practical Move

Ask two separate questions rather than one. First: does my parent qualify for Medicare-covered home health right now? Second: who is going to be here the rest of the week? The answers come from different places, and mixing them up is what costs families time.

If you or an aging loved one is considering home care in Chesapeake, VA, please contact the caring staff at Life’s At Home Care today! Chesapeake Office (757) 337-5160

Richmond Office (804) 396-6000

Life’s at Home Care is a top provider of home care services in Suffolk, Hampton, Virginia Beach, Portsmouth, Newport News, Norfolk, Chesapeake, Chesterfield, Hanover, Henrico, and the Richmond, Virginia area.

Sources:

• Medicare Rights Center, Understanding Medicare Home Health Care, January 2026, for covered services, exclusions, and 60-day certification periods.
• National Council on Aging and Center for Medicare Advocacy for the homebound and intermittent skilled care standards.

Life's At Home Care

Life’s At Home Care serves the Hampton Roads and Richmond areas as a state-licensed and certified home care agency. We send a VA home health aide to assist you with activities of daily living. Our reliable services help improve your comfort, convenience, health and safety.

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