How Much Does Medicare Pay for Caregivers?

Medicare is a federal health insurance program. Understanding how it covers caregiver services can be complex. The program covers specific medical and health-related needs, which influences its approach to services provided by caregivers.

Medicare Coverage for Skilled Care

Medicare Part A covers skilled care provided in a skilled nursing facility (SNF) under specific conditions. It covers services requiring trained professionals, such as skilled nursing, physical therapy, occupational therapy, and speech-language pathology. Care is considered skilled if it is medically necessary and can only be provided by or under the supervision of skilled personnel.

To qualify for SNF coverage, an individual must have had a qualifying hospital stay of at least three consecutive days. Admission to the SNF must occur within 30 days of hospital discharge, and the SNF care must relate to the hospital stay or a related condition that developed during SNF care.

Medicare covers the full cost for the first 20 days of a SNF stay within a benefit period. For days 21 through 100, a daily coinsurance applies, which is $209.50 per day in 2025. After 100 days in a benefit period, the individual is responsible for all costs. A new benefit period begins after 60 consecutive days without inpatient hospital or skilled nursing facility care.

Medicare Coverage for Home Health and Hospice

Medicare Part A and/or Part B cover home health services when an individual is homebound and requires intermittent skilled nursing care or therapy services. Being homebound means it is difficult to leave home without assistance or that leaving is not recommended due to a medical condition. A doctor must order the care, and a Medicare-certified home health agency must provide it.

Covered services include intermittent skilled nursing, physical, occupational, and speech-language therapy. Home health aide services, such as help with bathing or dressing, are covered only if skilled services are also being provided. These services are part-time or intermittent, meaning less than eight hours a day and 28 to 35 hours per week. Medicare does not cover 24-hour-a-day care at home. There are no copayments or deductibles for covered home health services, although a 20% coinsurance may apply to durable medical equipment.

Medicare Part A also covers hospice care for individuals with a life expectancy of six months or less, certified by a doctor. Hospice care is designed for comfort and pain management rather than curative treatment. This benefit includes:

• Nursing care
• Social services
• Medical supplies
• Equipment
• Grief counseling for the family

Caregiver support is often integrated into hospice, encompassing help with daily activities and respite care, which provides short-term inpatient stays to give caregivers a break. Hospice coverage begins with two 90-day benefit periods, followed by an unlimited number of 60-day periods, provided the individual continues to meet eligibility criteria.

Limitations on Medicare Coverage for Caregivers

Medicare does not cover services considered purely custodial care. Custodial care involves non-medical assistance with activities of daily living (ADLs), such as bathing, dressing, eating, or using the toilet, when these are the only types of care needed. This type of care can be provided safely by individuals without professional medical training. If a person only needs help with ADLs and does not require skilled nursing or therapy, Medicare will not pay for personal care aides or family caregiver services.

Medicare also does not cover long-term care, which includes extended stays in nursing homes primarily for custodial care, assisted living facilities, or adult day care. The program is structured to address acute medical needs and skilled rehabilitation. It does not provide ongoing support for chronic conditions or assistance with daily living when medical necessity for skilled care is not present.

Medicare Advantage Plans and Caregiver Support

Medicare Advantage plans (Part C) are offered by private companies and must cover at least the same services as Original Medicare. These plans may provide additional benefits not available through Original Medicare. Some Medicare Advantage plans offer supplemental benefits that can include non-medical services or support for caregivers.

These benefits can vary widely by plan and geographic location. Examples of such supplemental benefits may include in-home support services, transportation assistance, or adult day care. Beneficiaries considering these plans should carefully review specific plan details to understand the scope of caregiver support and other additional benefits offered.