No. Medicare does not cover 24-hour or continuous home care. The Medicare home health benefit covers intermittent skilled nursing and therapy visits — not around-the-clock presence. If a senior needs continuous supervision or personal care, that care must be privately paid, funded by Medicaid personal attendant programs for eligible individuals, or provided by family caregivers.

To be homebound under Medicare, leaving home must require “considerable and taxing effort” — either because of illness, injury, or functional limitation. A person can leave home occasionally for medical appointments, adult day programs, or infrequent outings and still qualify as homebound. A person who goes out regularly for errands, shopping, or social activities is typically not considered homebound for Medicare purposes.

Some home health agencies offer both Medicare-certified skilled care and private-pay personal care services. When a patient is receiving Medicare home health, the agency may also provide home health aide visits (personal care) as part of the Medicare plan of care — but only when a skilled need also exists and the aide visits are ancillary to the skilled care. Once skilled care ends, Medicare does not continue to cover aide services.

Texas Medicaid STAR+PLUS funds personal attendant services (bathing, dressing, meal preparation) through the Community First Choice benefit for eligible members. HCBS waiver programs also cover personal care for community-dwelling Medicaid members. Some Area Agency on Aging programs provide limited personal care services for lower-income seniors not on Medicaid. Veterans may qualify for VA community care benefits. Private pay remains the most common funding source for non-skilled home care in Texas.