What is the difference between Medicare Advantage and Original Medicare for home care?

Original Medicare (Parts A and B) covers Medicare-certified skilled home health: intermittent RN visits, physical therapy, occupational therapy, speech therapy, medical social work, and a home health aide when tied to a skilled service. All of that requires a physician order, homebound status, and delivery by a Medicare-certified home health agency. It is short-term and skilled — not ongoing daily support.

Medicare Advantage plans (Part C) are Medicare-approved plans run by private insurers. They must cover everything Original Medicare covers, including skilled home health. Additionally, since 2019 the plans have been permitted to offer supplemental non-medical benefits — including limited in-home support hours. That is the only way any form of Medicare pays for non-medical home care.

The supplemental in-home support benefit, when offered, typically ranges 24–124 hours per year and requires plan-specific documentation and an in-network agency. It is not a replacement for ongoing daily care — it is a supplement that helps in specific windows (post-discharge, respite, caregiver hospitalization).

For families in Southeast Michigan planning ongoing home care, neither Original Medicare nor Medicare Advantage funds the plan. Ongoing hours are funded through private pay ($27–$42/hr agency), long-term care insurance, VA Aid & Attendance, or the MI Choice waiver — with any MA supplemental hours used as a bonus on top.

For the full breakdown, see the cornerstone: Medicare Advantage and Home Care guide.