"Home-based medical care" includes services such as:

• House calls that doctors, nurse practitioners, and physician assistants make to a person’s home.
• Care that nurses, personal care aides, and therapy staff give to people with medical needs at home. These staff often work for home health agencies.
• Changes to the home and durable medical equipment that help people with medical needs and disabilities with daily tasks.

Geriatric Assessment

Older adults who have trouble leaving home often have many health problems and disabilities. These adults can benefit from a full health check called a comprehensive geriatric assessment. This check helps the health care provider:

• Learn about a person’s basic health and ability to function
• Find and diagnose health conditions
• Assess cognition if appropriate
• Make a care plan and schedule follow-up visits
• Manage care and suggest long-term care options (like nursing homes or assisted living) if needed

The health care provider uses this check to look at the older adult’s:

• Physical and mental health
• Vision, hearing, and balance
• Medications and nutrition
• Cognition (the ability to think, learn, and remember)
• Mood
• Ability to do daily tasks
• Quality of life
• Social activities and support
• Home setting and safety

Advantages of Assessment at Home

Doing the check at home helps the provider see how the older adult and family caregivers manage medical care and any disabilities. Home visits can empower patients and help them feel more involved in their care.

The health care provider can also check on the caregiver’s:

• Ability to meet the older adult’s needs.
• Their own health needs and how the caregiving affects them. For example, the caregiver may need short breaks (called respite) or training.

Role of Healthcare Professionals in Home Health Care

A primary care provider (a doctor, nurse practitioner, or other health care professional) usually leads a team that manages a person’s home health care. The team may include:

• Doctors, nurses, and social workers
• Therapists (speech, physical, occupational, and respiratory)
• Social workers, community health workers, and care coordinators
• Personal care aides
• Medical equipment suppliers
• Family caregivers, who often provide most of the day-to-day care

The team works with the older adult or their representative and family caregivers to meet the adult’s health care goals. The team’s goals are to:

• Find out what the older adult needs and wants for their health care
• Create, approve, and renew the older adult’s care plan. Approving the plan means making sure the home health care meets insurance rules. Medicare covers a majority older adults, so its rules usually apply.

Home Health

Home health refers to services given by nurses, therapy staff (physical, occupational, and speech therapists), and aides from home health agencies.

Home health care can help people who:

• Have trouble moving around
• Have wounds or other medical needs that require a skilled nurse
• Need to learn more about their health condition and how to prevent future problems
• Need help with bathing, dressing, and preparing meals
• Need care and emotional support when they are dying

Medicare Coverage

Medicare pays for home health care within certain limits. The rules are:

• The person must be “confined to home.” This means they have a very hard time leaving home. A person can still qualify even if they leave home for short outings.
• The person must need medically-related services, such as skilled nursing or physical therapy.

Read the Centers for Medicare and Medicaid Services booklet on Medicare and Home Health Care for more information.

House Call Services

A house call happens when a health care provider visits a person at home. For example, a doctor can examine a person at home to check on their care and see what their home is like. This can help the provider spot problems that might not come up during an office visit.

For example, a house call may show that:

• Family caregivers are too fatigued or need more supports/training
• The older adult is being abused
• Medications are not being used correctly or are being used differently than how the health care team recommended
• There are fall hazards like poor lighting or loose rugs

House calls also help older adults who have a hard time leaving home to see a doctor.

Limitations of House Calls and Home Health

Most older adults can stay in their own homes. But sometimes this may not be possible. For example:

• The older adult may not have any family caregivers.
• Family caregivers may have health problems or too much stress. This could limit how much care they can safely give.
• Serious medical problems may require repeated tests, breathing treatments, or IV (intravenous) medications that necesitate a hospital or skilled nursing home stay.
• The home itself may be a problem. For example, home health staff may not be able to go to an unsafe neighborhood, or the home may not have room for medical equipment.
• The cost of home care may be too high for the older adult.

Home Assessment & Modification

A full health check done in the older adult’s home may show that changes to the home or new equipment can help the person do daily tasks.

Environmental modifications

Examples of changes to the home include:

• A hand-held shower head, a shower seat, bathtub grab bars, or a bedside commode to make bathing and using the toilet easier.
• Removing barriers for wheelchairs and walkers (such as door thresholds), and adding chair lifts and outdoor ramps to enhance mobility.

An occupational therapist can suggest other personal care tools for daily tasks and household chores.

There are many home safety checklists available to help with a home check.

Assistive technology

Some tools can help older adults be more independent, including:

• A necklace or wrist device the older adult can use to call for help.
• Emergency response systems that ask the older adult to press a button each day by a set time. If they do not press it, the system will trigger an emergency response or a check-up phone call.
• Technology that can help:
  • Give and track medications
  • Monitor and send vital signs, like blood pressure
  • Connect to health care providers by video
  • Control heating, lighting, and doors from a distance
• Mobile testing tools used at home (home diagnostics), including X-rays, electrocardiograms (ECGs), and handheld lab devices. These tools allow for better medical care at home.

Payment for Home Health Care

Medicare often pays for home health care and for health care providers to visit older adults in their homes.

However, Medicare usually does not pay for home changes, simpler assistive tools, or the type of home care that is not medically related (like help with personal care). The older adult would need to pay for this out of pocket.

Medicaid is an option for older adults who have little money or who have used up their savings on care.

Each state’s Medicaid program pays for home care and home changes in different ways. The older adult or their representative needs to find out how Medicaid works in their state.

Last Reviewed and Updated: October 2026 
By: AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers