The Truth About Custodial vs. Medical Care

If you’ve ever wished Medicare would cover a little help around the house — someone to cook, clean, or keep you company — you’re not alone. This question comes up all the time, especially as people get older and want to stay in their homes safely and comfortably. So, does Medicare step in when you just need a hand with daily living?Let’s break down what is covered… and what, sadly, isn’t.

What Medicare Does Cover: Skilled or Medical Care

Medicare covers skilled care — the kind that requires licensed professionals such as nurses or physical therapists. This can include:

• Wound care or injections by a registered nurse
• Physical, occupational, or speech therapy after an illness or injury
• Part-time skilled nursing care following a hospital stay

This kind of care is considered medical, meaning it’s ordered by a doctor and tied to a specific health condition. If you qualify, it’s typically covered under Medicare Part A (for home health after a hospital stay) or Part B (for outpatient and ongoing skilled services).

What Medicare Doesn’t Cover: Custodial or Personal Care

Now here’s where most people get tripped up. Medicare does not cover what’s called custodial care. That means help with everyday activities such as:

• Cooking, cleaning, or laundry
• Grocery shopping or errands
• Bathing, dressing, or toileting (if not medically necessary)
• Companionship or supervision

Even if these services are essential for your comfort and safety, Medicare doesn’t consider them “medical.” So unless you’re receiving skilled care at the same time, they’re not covered.

There Are a Few Exceptions

Some Medicare Advantage plans (Part C) go above and beyond by offering in-home support benefits — like help with light housekeeping, meal prep, transportation, or even safety modifications. These extras are meant to help people stay independent and prevent hospitalizations. The catch? Not every plan offers them, and they’re only available to members who qualify based on health needs.

The Bottom Line

Medicare pays for medical help, not household help — but that doesn’t mean you’re out of options.

Some newer plans are starting to recognize that staying independent is part of staying healthy.

That’s where I come in — I’ll help you explore plans that offer the support you need, so you can stay in your home and keep your independence without feeling overwhelmed.

Tip:

If you or a loved one needs more day-to-day help at home, look into:

• Medicare Advantage plans with home support services
• Long-term care insurance (for custodial or extended care)
• Community and county programs that offer home assistance to seniors

It’s not always about what Medicare pays for — it’s about combining the right resources to make life easier and safer.

Doreen Marino | 65+ Insurance Solutions | www.dmarinomedicare.com