Home Health in Delaware

Delaware Division of Services for Aging and Adults with Physical Disabilities connects Delaware seniors and families with local aging services, Area Agencies on Aging, and information about home health providers and other long-term care options in the state.

Delaware Medicaid administers the home health and Home and Community Based Services (HCBS) waiver programs that may cover skilled home health services for eligible low-income seniors. Contact the state Medicaid office for eligibility screening and enrollment information.

Medicare Care Compare is the official federal tool to search, compare, and review quality star ratings for all Medicare-certified home health agencies in Delaware. Ratings are based on patient outcomes and patient experience surveys.

Medicare Home Health Booklet is an official Medicare.gov publication explaining who qualifies for home health, what services are covered, what patients pay, and how to appeal a coverage decision.

Eldercare Locator is a free service of the U.S. Administration on Aging that helps Delaware seniors and families find local home health, personal care, transportation, and other aging services in their community. Phone: 1-800-677-1116

Delaware's home health landscape is supported by major medical centers including ChristianaCare (Newark and Wilmington) and Bayhealth Medical Center, which serve as key referral sources for Medicare and Medicaid home health episodes. The state has a humid subtropical to continental climate with mild winters, which influences both care delivery logistics and the health conditions most commonly managed at home. Delaware does not tax Social Security income and offers additional tax relief for qualifying seniors.

Delaware Medicaid operates the Diamond State Health Plan Plus LTSS (Medicaid Managed Care LTSS), which covers home health and personal care services for eligible seniors who meet both financial and level-of-care requirements. The highest concentration of Medicare-certified home health agencies is in Wilmington, Dover, and the Brandywine corridor, with growing coverage in suburban and rural communities statewide.

Medicaid eligibility for home health services is determined individually, based on both financial need and a demonstrated level of care requirement - not every senior will qualify. Even when Medicaid eligibility is confirmed, not every home health agency accepts Medicaid as a payment source. Families are encouraged to confirm individual agency Medicaid acceptance policies before beginning the enrollment process.

Home Health Care is skilled medical care delivered directly inside a patient's home by licensed healthcare professionals. It is not the same as non-medical Home Care or companion care. Home Health is ordered by a physician or other qualified provider and carried out by registered nurses, physical therapists, occupational therapists, and speech-language pathologists who follow a structured, physician-directed treatment plan.

Services typically begin following a hospitalization, surgery, or significant change in medical condition. The goal is to allow seniors to recover and manage complex health needs in the comfort of their own home, without requiring placement in a nursing facility or continued hospital stay.

The Home Health sector is substantial. According to the 2025 National Alliance for Care at Home Chartbook, there were 9,961 Medicare-certified Home Health agencies operating in the United States in 2024, serving approximately 2.7 million traditional Medicare beneficiaries and employing 1.758 million people - an increase of 18.2% from 2020. Just 6.2% of all Medicare beneficiaries currently utilize home health services, suggesting that many eligible seniors are unaware of what the benefit covers or how to access it.

How Home Health differs from other in-home services

Home Health is a medical service directed by a physician or qualified provider. This is what sets it apart from non-medical Home Care, which assists with daily tasks like bathing, dressing, and meal preparation but does not involve licensed clinical professionals and does not require a physician's order. Home Health also differs from facility-based care such as skilled nursing facilities or assisted living communities, because Home Health is delivered in the patient's home on a scheduled, intermittent visit basis rather than in a 24-hour residential setting.

Common reasons Home Health is ordered:

• Recovery following a hospital stay, surgery, or medical procedure
• Management of a new or worsening chronic condition such as heart failure, COPD, or diabetes
• Post-surgical wound care and monitoring
• Medication management following a significant health change
• Physical, occupational, or speech therapy after an illness or injury
• Disease education and self-management training for patients and family caregivers

Home Health is particularly valuable for individuals who need the clinical oversight of a nurse or therapist but do not require full-time institutional care. It supports recovery, promotes independence, and is one of the few senior care services with meaningful Medicare coverage for qualifying patients.

Home Health Care offers a combination of clinical quality and personal comfort that is difficult to match in any facility-based setting. For many families, it is the preferred option for post-acute recovery because it allows their loved one to receive professional medical oversight in a familiar environment.

Medical care delivered to the patient Skilled nursing and therapy services come directly to the patient. There is no transportation required, no waiting rooms, and no disruption to daily routines. Care is provided where the patient is most comfortable.

One of the few senior care services with substantial Medicare coverage Home Health is one of the few services covered under both Medicare Part A and Part B. For patients who meet eligibility criteria, Medicare covers the full approved cost of covered services with no copay for the visits themselves. This makes it one of the most financially accessible forms of skilled care available to seniors.

Personalized, one-on-one attention Unlike a facility setting where clinical staff serve many residents simultaneously, Home Health visits are dedicated entirely to one patient. The clinician focuses entirely on your loved one's condition, goals, and specific recovery needs during every visit.

Coordinated care across providers Home Health agency staff will talk to your doctor or other provider about your care plan and keep them updated on your progress. This coordination helps ensure that everyone involved in the patient's care is aligned on treatment goals, medications, and clinical progress. 

Supports aging in place For seniors who want to remain in their own home, Home Health makes it possible to receive clinical-level care without transitioning to a facility. This is particularly meaningful for individuals managing chronic conditions over time, where ongoing professional support can help maintain function and quality of life.

A structured, accountable model of care Home Health is not informal assistance. Every patient receives a written care plan developed by a licensed professional in coordination with their physician. This plan defines the services, goals, frequency of visits, and anticipated duration, creating a framework of accountability for both the agency and the clinical team.

Access to durable medical equipment In addition to skilled visits, Medicare also covers durable medical equipment such as a wheelchair or walker, typically 80% of the Medicare-approved amount, as long as it meets certain criteria. This can be an important support for patients managing mobility limitations at home. 

Home Health has broader insurance coverage than most other in-home senior care services. Understanding the eligibility criteria for each payer source helps families avoid surprises and plan more confidently.

What Home Health typically costs without insurance

The 2025 CareScout Cost of Care Survey, which collected more than 25,000 rates from providers across the country between July and November 2025, provides the most current national cost benchmarks available.

The national median hourly rate for non-medical caregiver services (which includes home health aide and homemaker services, now reported together due to price convergence) rose to $35 per hour in 2025, a 3% year-over-year increase. Based on 44 hours of care per week, annual costs reached $80,080. 

New to the 2025 survey, CareScout also reports for skilled nursing services delivered in the home - referred to as private duty nursing. The national median hourly rate for private duty nursing is $90 per hour, with a median per-visit rate of $160. 

Costs vary considerably by state and region. Wyoming had the highest rates for non-medical caregivers at $46 per hour, while Mississippi had the lowest at $24 per hour. For private duty nursing, Kentucky had the highest per-visit rate at $302, while Ohio had the lowest at $85 per visit. 

For comparison, the national median daily rate for a private room in a nursing home in 2025 was $355 per day ($129,575 annually), and a semi-private room was $315 per day ($114,975 annually). Home Health, particularly when Medicare-covered, is substantially more cost-effective than residential placement for patients who can be safely cared for at home. 

Medicare - Most Common Payer for Qualifying Patients

Medicare can pay for home health care under either Part A or Part B. Part A may apply after a recent hospital stay, while Part B usually covers care that is medically necessary even without a prior hospitalization. This is an important distinction that many families miss: a hospital stay is not always required to access Medicare-covered Home Health services. 

Medicare covers Home Health services when all of the following apply:

• The patient's care is ordered by a physician or other qualified provider
• A face-to-face encounter with the ordering provider has occurred within the required timeframe
• The patient meets Medicare's homebound criteria
• The care required is skilled, meaning it must be performed by or under the supervision of a licensed nurse or therapist
• Services are provided by a Medicare-certified Home Health agency
• The patient has Medicare Part A or Part B

For all covered home health services, patients pay nothing - no copayments or coinsurance. For durable medical equipment, patients pay 20% of the Medicare-approved amount after meeting the $257 Part B deductible in 2025. 

Important distinctions:

• A prior hospital stay is NOT required to qualify under Medicare Part B. If the patient is homebound and has a skilled care need, coverage may be available regardless.
• A home health plan of care and certification is valid for a finite period of 60 days, and can be renewed by a doctor for additional 60-day periods as needed. 
• Medicare does not cover 24-hour care, meal delivery, homemaker services, or personal care when it is the only service needed.
• Medicare is not a long-term care benefit. Coverage ends when the patient no longer has a skilled care need.
• Medicare Advantage (Part C) plans must provide the same home health coverage as Original Medicare. As of 2024, 13.7 million Americans were enrolled in both Medicare and Medicaid (dual eligible), which can expand home care options and reduce costs further.

Medicaid - For Qualifying Low-Income Individuals

Medicaid programs are administered at the state level, and eligibility rules, covered services, and benefit structures vary by state. Medicaid HCBS (Home and Community Based Services) is a long-term care benefit funded by state-level Medicaid waiver programs and may be available to Medicaid beneficiaries and dual-eligible Medicare-Medicaid beneficiaries depending on state rules. Unlike Medicare's skilled care requirement, Medicaid HCBS can fund longer-term personal care and support. 

Eligibility is based on income, assets, functional need, and state-specific criteria. If you are unsure whether a loved one qualifies, applying is worth doing. Eligibility is determined across a range of factors including household income, age, disability status, and family size.

Veterans Aid and Attendance Benefit

The Aid and Attendance benefit is a pension enhancement available to qualifying wartime veterans and surviving spouses who need assistance with activities of daily living. You may be eligible if you need another person to help you perform daily activities like bathing, feeding, and dressing; if you have to stay in bed due to illness; if you are a patient in a nursing home due to the loss of mental or physical abilities; or if your eyesight is significantly limited. The benefit is completely tax-free and does not need to be repaid. 

The VA announced a 2.8% cost-of-living adjustment for 2026, effective December 1, 2025. Current maximum monthly benefit amounts (effective December 2025 through November 2026): 

• Single veteran: up to $2,424 per month
• Married veteran: up to $2,874 per month
• Two veterans married to each other, both qualifying: up to $3,845 per month
• Surviving spouse of a deceased veteran: up to $1,558 per month

The net worth limit to be eligible for Veterans Pension benefits from December 1, 2025 to November 30, 2026 is $163,699. The net worth calculation includes assets and annual income but excludes the primary residence, one vehicle, and personal household furnishings. The VA enforces a 36-month look-back period on asset transfers. Actual benefit amounts are calculated as the difference between the Maximum Annual Pension Rate and countable income after deducting allowable unreimbursed medical expenses. 

Private Health Insurance

Most private health insurance plans cover some Home Health services for acute medical needs. Coverage for longer-term or extended care varies significantly by plan. Review your policy carefully, confirm how many visits are authorized, and ask whether prior authorization is required before care begins. Contact your insurer directly before assuming coverage, as home health benefits are not standardized across plans.

Long-Term Care Insurance

Long-term care insurance policies vary widely. Some include Home Health benefits; others are limited to facility-based care. Review the policy's benefit triggers, elimination period (the waiting period before benefits begin), and daily or monthly benefit amount. If a policy is in place, notify the insurer promptly when care is initiated to begin the claims process and avoid losing reimbursable days.

Private Pay

Families who do not qualify for coverage programs may pay for Home Health services with private funds including personal savings, retirement income, pension payments, or contributions from family members. Many agencies can work with families to structure visit frequency in a way that fits within a defined budget.

Selecting the right Home Health agency is one of the most consequential decisions a family makes during a care transition. Quality, staffing standards, and communication practices vary meaningfully from one agency to the next.

Start with credentials and certification

Before evaluating anything else, verify the agency holds appropriate credentials:

• Medicare certification is required for services to be covered by Medicare. Confirm the agency appears in Medicare's Care Compare database at medicare.gov/care-compare.
• State licensure requirements vary. Some states require Home Health agencies to be licensed; others do not. Confirm the agency is in good standing with your state's relevant regulatory body.
• National accreditation from organizations such as The Joint Commission or CHAP (Community Health Accreditation Partner) signals that the agency has met independently verified standards for quality and operational safety. Ask whether any accrediting body certifies the agency.

Check quality ratings through Medicare Care Compare

CMS publishes star ratings for Home Health agencies on Care Compare, which summarize publicly reported measures of home health provider performance. The tool provides ratings across two categories: quality of patient care and patient experience (based on patient surveys). Review ratings across both categories and look at any available inspection reports. Star ratings are updated periodically based on recent claims and survey data.

Evaluate services offered and geographic coverage

Confirm the agency provides the specific services your loved one needs - whether skilled nursing, physical therapy, occupational therapy, speech therapy, home health aide services, or medical social work. Also confirm the agency actively serves your specific area. Many agencies have defined geographic service zones and may not cover all parts of a given county.

Ask about staffing and supervisory structure

• What are the credentials and clinical experience of the professionals assigned to your case?
• Are supervising nurses available to provide clinical oversight between scheduled visits?
• Is after-hours clinical support available by phone if a concern arises outside of visit times?
• What is the agency's process when a scheduled clinician is unavailable?
• Are clinicians employed directly by the agency or contracted independently? Directly employed staff are typically covered under the agency's own liability insurance and background screening protocols.

Understand the care plan and communication process

A quality agency will develop a written care plan before services begin. Ask:

• Will the home health agency tell me how much Medicare will pay before care starts, and will they advise me in writing about any items or services that Medicare won't cover? 
• Is a written care plan provided at the start of services that outlines every service, the responsible clinician, visit frequency, and treatment goals?
• How does the agency communicate progress to the referring physician?
• How are families updated when there is a change in condition?
• What is the formal process for raising a concern or complaint?
• Does the agency provide a Patients' Bill of Rights describing both patient rights and agency responsibilities?

Additional questions worth asking before selecting an agency

• How long has this agency been operating in this community?
• Is the agency currently in good standing with state regulators?
• Is clinical supervision available around the clock, seven days a week?
• How does the agency handle scheduling when a regular clinician is unavailable?
• How is patient confidentiality protected and maintained?
• Does the agency have experience with your loved one's specific diagnosis or condition?
• Is there a sliding fee schedule or financial assistance available for families who need it?
• Does the agency accept the insurance coverage your loved one has?