Are Medicare Home Health Service Copayments Coming Back?

The Medicare home health benefit does not impose a copayment on its beneficiaries, but many in Congress and the Administration are weighing the possibility of saddling a vulnerable population with additional out-of-pocket costs. Despite having Medicare, people 65 or older are most likely to say that cost poses a barrier to care, according to a study by the Commonwealth Fund. Nineteen percent said cost was the reason they did not visit a doctor; they skipped a medical test or treatment recommended by a doctor; did not fill a prescription; or skipped doses.

In fact, home health beneficiaries are older, poorer, sicker, and more likely to be from a minority population than Medicare beneficiaries as a whole. Data from Avalere Health indicates that 24% of home health recipients are over 85 compared to just 12% of all other Medicare beneficiaries. Sixty-six percent of home health seniors live at or below 200% of the Federal Poverty Level compared to just 48% of all other Medicare beneficiaries.

Additionally, 75% of seniors who get the Medicare home health benefit have four or more chronic conditions compared to just 49% of the general Medicare population. Eric Berger, CEO of the Partnership for Quality Home Healthcare, said, “Congress repealed the home health copayment in 1972 for a very good reason. It failed to reduce healthcare costs and instead drove seniors to higher-cost institutional settings. Re-imposition of such failed policy has the potential to compel poor seniors to forego cost-effective home healthcare simply because they cannot pay.” For more information, visit

Last Updated 08/10/2022

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