TRICARE Home Health Care: Coverage, Costs & Rules (2026) | TRICARE.com

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## Quick answer TRICARE covers home health care when it is medically necessary and a doctor certifies you are "homebound." This benefit provides part-time or intermittent skilled nursing care, physical therapy, and home health aide services at little to no cost for most beneficiaries, provided the services are received from a TRICARE-authorized home health agency.

Details

TRICARE utilizes the **Home Health Prospective Payment System (HHPPS)**, which mimics the Medicare model. To qualify, a patient must be under the care of a physician and require skilled services that cannot be safely performed by a layperson.

### What is Covered * **Skilled Nursing Care:** Part-time or intermittent care provided by an RN or LPN. * **Therapy Services:** Physical, occupational, and speech-language pathology. * **Home Health Aides:** Support with "activities of daily living" (bathing, dressing, etc.), but only if you are also receiving skilled nursing or therapy. * **Medical Social Services:** Counseling to help deal with the social and emotional effects of an illness. * **Medical Supplies:** Routine supplies (bandages, catheters) used during the visit are generally included in the payment TRICARE makes to the agency.

### The "Homebound" Requirement You are considered homebound if leaving the home requires a taxing effort or the assistance of another person/medical equipment. You may leave for medical appointments or brief, infrequent non-medical reasons (like a funeral or religious service) and still qualify.

### 2026 Costs and Coverage Limits * **Active Duty Service Members (ADSMs):** $0 out-of-pocket, but require a referral and pre-authorization. * **TRICARE Prime (Retirees/Families):** No copayments for home health services from network providers. * **TRICARE Select:** Generally no copayment for home health visits, but you may be responsible for a cost-share if the services aren't part of an episode of care or if you use a non-network provider. * **Durable Medical Equipment (DME):** While home health visits are often $0, if the agency provides DME (like a hospital bed or wheelchair) for home use, you will typically owe a 10%–20% cost-share depending on your plan and sponsor status (2026 rates).

### Regional Contractors Authorization for home health care is managed by the regional contractor: * **East Region:** Humana Military. * **West Region:** TriWest Healthcare Alliance.

### What is NOT Covered TRICARE does **not** cover: * 24-hour-a-day "round-the-clock" nursing care at home. * Meals delivered to your home (e.g., Meals on Wheels). * Homemaker services (shopping, cleaning, laundry) if that is the only care you need.

## Who this affects * **Active Duty Service Members and Families:** Fully covered with authorized referrals. * **Retirees and their Families:** Covered; TRICARE For Life beneficiaries must use Medicare-certified agencies. * **National Guard and Reserve:** Covered under TRICARE Reserve Select if the homebound criteria are met. * **Survivors and Medically Retired:** Eligible for the same benefits as standard retirees.

## Sources 1. **TRICARE.mil:** Home Health Care Overview - [https://www.tricare.mil/CoveredServices/IsItCovered/HomeHealthCare](https://www.tricare.mil/CoveredServices/IsItCovered/HomeHealthCare) 2. **TriWest Healthcare Alliance (West Region):** [https://www.triwest.com](https://www.triwest.com) 3. **Humana Military (East Region):** [https://www.humanamilitary.com](https://www.humanamilitary.com) 4. **Health.mil:** Defense Health Agency (DHA) Policy Manuals - [https://health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/Home-Health-Care](https://health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/Home-Health-Care)