Skilled Nursing at Home: What Medicare Will and Won’t Cover

The short answer

Medicare covers intermittent skilled nursing care at home — not 24-hour care, and not custodial help with bathing, dressing, or meal prep on its own. To qualify, a Medicare beneficiary needs to be homebound, under a doctor’s care plan, and need a skilled service that only a licensed nurse can provide.

What counts as “skilled”

• Wound care after surgery or for chronic conditions
• IV antibiotic administration
• Injections that require professional technique
• Catheter or ostomy management
• Patient and family education on a new diagnosis
• Monitoring of an unstable medical condition

What’s not covered

Medicare won’t pay for hands-on help with daily living that doesn’t require a nurse — that’s where caregiving services come in. The two are often used together: a skilled nurse stops by three times a week for wound care while a caregiver handles meals, mobility, and companionship the rest of the time.

How to start

Your doctor orders skilled nursing, and a Medicare-certified agency manages the visits. The agency handles billing directly with Medicare in most cases, so families rarely see a bill for the nursing portion.

Questions about whether your situation qualifies? Call us at 305-363-7755.