How to Get Home Health Care for Seniors Through Medicare

As India’s elderly population continues to rise, the demand for quality and accessible Best Caregiver Services at Home has surged. Families want their senior loved ones to receive medical attention, personal care, and emotional support — all within the comfort of their homes. For many, the question is: can we get these services through a health scheme like Medicare?

While Medicare in its original form is a U.S.-based government program, Indian families can access similar home health care benefits through government schemes like Ayushman Bharat, CGHS, ESIC, and private Medicare-type insurance. In this blog post, we’ll guide you through how Indian senior citizens can access home health care under Medicare-type coverage, what’s included, eligibility requirements, and how to apply.

What Is Home Health Care?

Home health care refers to a range of medical and personal support services provided at the patient's residence. It is ideal for seniors recovering from illness, living with chronic conditions, or needing daily support.

Key services include:

• Skilled nursing care (injections, wound care, catheter, IV, etc.)
• Physiotherapy and rehabilitation
• Personal care (bathing, grooming, feeding)
• Doctor visits at home
• Medical equipment support (oxygen, walkers, etc.)
• Palliative and hospice care

Does Medicare Cover Home Health Care in India?

In the U.S., Medicare provides comprehensive home care for seniors aged 65 and older. In India, we have no exact Medicare equivalent, but similar benefits are available under these options:

1. Ayushman Bharat - PMJAY
2. Central Government Health Scheme (CGHS)
3. Employees' State Insurance Scheme (ESIC)
4. Private health insurance with home care riders
5. State health insurance schemes

Ayushman Bharat (PM-JAY) and Home Health Care

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is India’s largest government-funded healthcare scheme.

• Eligibility: Families listed in SECC 2011 database or with PMJAY Golden Card.
• Coverage: Up to ₹5 lakh per family annually.
• Home Health Benefits: Some empanelled hospitals and providers offer post-hospitalisation care at home, including nursing, physiotherapy, and diagnostics.

How to Apply:

• Check eligibility at
• Obtain the Golden Card from the nearest CSC or hospital.
• Choose an empanelled hospital or care provider that offers home care packages.

CGHS (Central Government Health Scheme)

CGHS serves retired and current Central Government employees and their dependents.

• Eligibility: Central govt pensioners, employees, MPs, etc.
• Benefits: Reimbursement or cashless medical services through empanelled hospitals.
• Home Care: In cases like chronic illness or disability, home visits by doctors, nurses, or physiotherapists may be approved.

Process:

• Approach your CGHS Wellness Centre or empanelled hospital.
• Obtain referral from a CGHS medical officer.
• Submit necessary documents and approval form for home-based treatment.

ESIC (Employees' State Insurance Corporation)

ESIC covers employees earning ₹21,000/month or less in the organised sector.

• Eligibility: Insured persons and their dependent parents/spouses.
• Home Health Benefits: For terminally ill or bedridden patients, home medical care including nursing and medication may be allowed.
• Facilities: ESIC Model Hospitals sometimes provide such care through mobile units.

Private Medicare-Type Insurance with Home Care

Many private insurers now offer home health care benefits under Senior Care Services health insurance or critical illness plans.

Popular insurers offering such benefits:

• HDFC ERGO
• Niva Bupa (Max Bupa)
• Care Health Insurance
• Star Health Senior Citizen Red Carpet

Covered services may include:

• Doctor and nurse visits
• Post-surgical home recovery
• Physiotherapy sessions
• Home diagnostic tests

Check your policy for terms like:

• "Home Hospitalisation"
• "Domiciliary Care"
• "Post-Hospitalisation Home Care"

State-Specific Government Schemes

Many Indian states offer health insurance schemes for seniors, such as:

• Arogya Karnataka
• Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) – Maharashtra
• Swasthya Sathi – West Bengal
• Bhamashah Swasthya Bima Yojana – Rajasthan

Some state plans cover rehabilitative home care after surgery or hospitalisation. Eligibility varies based on ration card or income level.

How to Find a Registered Home Health Care Provider

To claim home care under any of these schemes or insurance plans, services must be provided by licensed or empanelled agencies.

Top Indian home healthcare providers include:

• Portea Medical
• Healthcare atHOME (HCAH)
• Apollo HomeCare
• Medwell (Nightingales)
• Care24

Ensure the provider is:

• Registered under Clinical Establishments Act
• Empanelled with your insurance or scheme
• Provides qualified nurses and therapists
• Offers transparent billing

Steps to Get Home Health Care for Seniors via Medicare-Type Cover

1. Verify Scheme Eligibility: Identify whether the senior is eligible for PM-JAY, CGHS, ESIC, or private health insurance.
2. Get Prescribed by a Doctor: A medical prescription recommending home care is usually mandatory.
3. Choose a Registered Provider: Select a licensed agency empanelled under your health scheme or insurer.
4. Submit Pre-Authorization: Share documents like ID proof, medical history, and doctor's recommendation for approval.
5. Start Services at Home: Once approved, care can begin. Track the services and maintain receipts if reimbursement is required.

Common Challenges & Solutions

Challenge	Solution
Unawareness of scheme benefits	Consult local ASHA workers or visit official scheme websites
Delayed approval	Follow up with insurance TPA or local nodal officer
Lack of nearby home care providers	Request for mobile medical units if available
Coverage limits	Buy supplemental private health insurance for home care

Tips for Families

• Keep all medical documents and prescriptions safely.
• Maintain a caregiver logbook for insurance or scheme audits.
• Use digital apps like Aarogya Setu, PM-JAY App, or insurer apps to track status.
• Always verify credentials of caregivers and nurses visiting home.
• If possible, install basic medical devices at home (BP monitor, glucometer, etc.).

Conclusion

While India may not have a Medicare system identical to the U.S., there are robust alternatives for accessing home health care for senior citizens. Whether through government schemes like Ayushman Bharat or CGHS, or via private insurers, you can secure safe and skilled care for your aging loved ones in the comfort of your home.

By understanding eligibility, navigating the application process, and choosing licensed providers, families can ensure their elders receive the compassionate, medical-grade care they deserve — without unnecessary hospital visits or financial strain.