Does TRICARE Cover Home Health Care? 2026 Coverage Guide | TRICARE.com

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## Quick answer Yes, TRICARE covers home health care when it is medically necessary and ordered by a doctor as part of a formal treatment plan. This typically includes intermittent skilled nursing care, physical therapy, and speech-language pathology for patients who are homebound.

## Details TRICARE’s home health benefit is designed to provide short-term, skilled care for beneficiaries who are confined to their home. To qualify, a physician must certify that you are homebound and require "intermittent" skilled care, meaning care is provided on a part-time basis rather than 24/7 supervision.

### What is Covered Under the Home Health Agency (HHA) prospective payment system, TRICARE covers: * **Skilled Nursing Care:** Provided by a Registered Nurse (RN) or Licensed Practical Nurse (LPN). * **Therapy Services:** Physical, occupational, and speech therapy. * **Home Health Aides:** Assistance with ADLs (Activities of Daily Living) like bathing or dressing, but only if the patient is also receiving skilled nursing or therapy. * **Medical Social Services:** Counseling related to the patient's medical condition. * **Medical Supplies:** Basic supplies provided by the agency (e.g., surgical dressings).

### What is NOT Covered TRICARE does not cover services that are primarily for convenience or long-term maintenance, such as: * 24-hour-a-day care at home. * Custodial care (assistance with walking, bathing, or eating when no skilled medical care is required). * Meals on Wheels or similar food delivery services. * Homemaker services like shopping, cleaning, or laundry.

### Costs and Copays (2026 Rates) Costs depend on your beneficiary category and the specific TRICARE plan you use. * **Active Duty Service Members (ADSMs):** $0 out-of-pocket for covered home health services. * **TRICARE Prime (Retirees/Families):** Generally $0 copayment for home health care from network providers, though point-of-service charges apply if you seek care without a referral. * **TRICARE Select (Group A and B):** Beneficiaries may have a cost-share for home health services, typically calculated as a percentage of the allowable charge after the annual deductible is met. For 2026, check your specific "Plan B" or "Plan A" catastrophic cap and deductible limits via TRICARE.mil, as these adjust annually.

### Regional Management Home health care must be authorized by your regional contractor. Effective 2025 and continuing through 2026: * **East Region:** Managed by Humana Military. * **West Region:** Managed by TriWest Healthcare Alliance.

## Who this affects * **Active Duty Service Members:** Full coverage with 0% cost-share; requires prior authorization. * **Active Duty Family Members (ADFMs):** Covered under Prime and Select; requires physician certification of homebound status. * **Retirees and their Families:** Covered, though subject to applicable deductibles and cost-shares under Select. * **National Guard and Reserve:** Covered if enrolled in TRICARE Reserve Select (TRS) or on active duty orders for more than 30 days. * **Survivors:** Benefits remain consistent with the original sponsor's category.

## Sources * TRICARE.mil: [Home Health Care Overview](https://tricARE.mil/CoveredServices/IsItCovered/HomeHealthCare) * Humana Military (East): [Authorizations and Referrals](https://www.humanamilitary.com) * TriWest Healthcare Alliance (West): [Provider and Member Services](https://www.triwest.com) * Defense Health Agency (DHA): [Home Health Agency Pricing](https://health.mil)