Home Care After Surgery: What Your Family Should Know
Coming home after surgery is a big change. The hospital sends you home with papers about your care. You get a list of medicines. You might get a card for a follow-up visit. Then you are left to figure out the rest on your own.
This guide answers the questions families ask most. Does Medicare or Medicaid pay for home care? What does it cost if they don't? What should you expect based on the type of surgery? How do you know if home care is enough, or if you need more help?
Does Medicare or Medicaid Cover Home Care After Surgery?
Quick Answer
Medicare usually does not pay for non-medical home care, like help with bathing or meals. It can pay for skilled home health visits, like nursing or physical therapy, if a doctor orders them and the patient must stay home to recover. Medicaid may pay for non-medical home care too, but your state has to say yes first, after its own review. The rules are different in each state. (Current as of July 2026.)
That's the short answer. Here is what matters most for your plan:
- Medicare pays for skilled visits ordered by a doctor. This includes nursing, physical therapy, occupational therapy, and medical supplies tied to those visits. It does not pay for daily help with bathing, dressing, or meals over time. That kind of help is what most people need most after surgery.
- Medicaid can pay for non-medical home care. But the program name and the rules change by state, and only the state decides who qualifies, not any home care agency. We list the programs for New York, New Jersey, Maryland, Michigan, and Connecticut further down.
- If neither one covers your care, private pay is the usual choice. See the cost section later in this guide for real numbers.
Home Care vs. Home Health Care vs. a Rehab Facility
Quick Answer
Home care means non-medical help each day. This includes bathing, meals, and company. Home health care means clinical help from nurses or therapists. This includes wound checks, medicine management, and physical therapy. A doctor usually orders this. A rehab or skilled nursing facility is a short stay away from home. It is used when a patient needs many hours of therapy each day. That kind of therapy can't happen safely at home. Most surgeries only need the first two.
|
Non-Medical Home Care |
Home Health Care |
Rehab / Skilled Nursing Facility |
| Who provides it |
Trained home health aides, personal care aides |
RNs, LPNs, licensed therapists |
Full clinical staff, on-site 24/7 |
| What it covers |
Bathing, dressing, meals, mobility help, companionship |
Wound care, medication management, IV therapy, PT/OT |
Intensive multi-hour daily therapy, round-the-clock monitoring |
| Where it happens |
Patient's home |
Patient's home |
Inpatient facility |
| Typically ordered by |
Family choice, no doctor's order needed |
A doctor |
A doctor or hospital discharge team |
| Usual payer |
Private pay, or Medicaid for those who qualify |
Medicare (if criteria met), private insurance |
Medicare Part A (limited days), insurance, private pay |
| Best fit when |
Patient is medically stable and needs daily living support |
Patient needs clinical monitoring or therapy but is safe at home |
Patient needs therapy hours home care can't provide, or has no safe home setup |
When Home Care Is Enough, and When It Isn't
Home care is usually enough when:
- The patient can share what they need and follow simple steps
- There is no active infection, no bad pain, and vital signs are steady
- The home already has, or can quickly get, a basic safety setup (see the next section)
- Someone, like family or a caregiver, can be there for part of each day
Think about a rehab facility, a longer hospital stay, or 24/7 skilled nursing when:
- The recovery needs many hours of therapy each day. That's more than can happen at home.
- The home has no safe way in or out. Stairs may be too hard to manage, and it can't be fixed fast.
- The patient's health is not steady. It needs watching all the time, not just visits.
- No one can be home at all, even part-time. But the recovery truly needs supervision.
You may not be sure which one fits your case. That is normal. A home visit from a home care agency can help. So can a talk with the hospital discharge planner. Either one can usually help you decide in one conversation.
What to Expect by Surgery Type
Quick Answer
What you need depends a lot on the surgery. Joint replacements need a lot of physical therapy. They also need fall prevention. Cardiac surgery needs careful medicine management. It also needs slow increases in activity. Below is what recovery often looks like for the surgeries families ask about most. Your surgeon's plan always comes first, though.
Hip Replacement Recovery at Home
- Week 1: Help with walking, often with a walker. Pain control, wound checks, and watching for falls. Most daily tasks, like bathing, dressing, and meals, need help now.
- Weeks 2 to 4: Physical therapy sessions increase. The patient still needs help with stairs and moving around, but needs less help with daily tasks.
- Weeks 4 to 8: The focus shifts to strength and movement. Home care visits often drop to a few times a week instead of every day.
Knee Replacement Recovery at Home
- Week 1: Like hip surgery, but with more focus on swelling and early gentle movement, since knees get stiff fast.
- Weeks 2 to 6: Physical therapy often happens more than after hip surgery. Home care mostly helps with getting to PT and doing exercises between sessions.
- Weeks 6 to 12: Strength keeps building. Most patients need less daily help by now, though full healing can take months.
Cardiac Surgery Recovery at Home
- Weeks 1 to 2: Close watching matters a lot right now. Medicine management is key, especially blood thinners, and lifting limits are common. Skilled nursing visits often check the incision and watch for swelling or infection.
- Weeks 3 to 6: Cardiac rehab often starts now. Activity increases slowly, and only with guidance, not on the patient's own schedule.
- Weeks 6 to 12: Watching continues, but support drops slowly as the patient can do more.
Other Common Surgeries
- Abdominal surgery (hernia, gallbladder): 2 to 4 weeks of wound care, help moving, and meal prep
- Cataract or eye surgery: A few days to 2 weeks, mostly rides to appointments and medicine reminders
- Spinal surgery: 6 to 12 weeks, about as intense as cardiac and joint recoveries
- Mastectomy or breast surgery: 2 to 6 weeks of wound care, help dressing, and emotional support
- Oral or dental surgery: A few days to a week, mostly soft food and medicine reminders
Age and health problems change these timelines too. So do things like diabetes or heart disease. A healthy 45-year-old healing from a hernia repair often needs less help. An 80-year-old doing the same recovery, while also managing arthritis, often needs more.
Preparing the Home Before Surgery
Quick Answer
The best thing families can do before surgery is walk through the home and remove fall risks. Look for loose rugs, cluttered walkways, and any stairs that aren't needed. A few pieces of simple equipment make the first days home much easier.
Set Up Before Discharge Day
- Clear a path from the bed to the bathroom. Remove rugs or anything a foot or walker could catch on.
- If stairs are a problem, set up a recovery space on the main floor. A couch or recliner works if there is no bedroom down there.
- Put in grab bars near the toilet and in the shower if there isn't something sturdy already.
- Keep things used often, like the phone, water, medicine, and the remote, within easy reach of the recovery space.
- Add nightlights along the path to the bathroom for trips at night, when falls are most likely.
Equipment Worth Having, Depending on the Surgery
- A shower chair or bench, for anyone with hip, knee, or balance problems
- A raised toilet seat, especially after joint replacement
- A reacher or grabber tool, so bending isn't needed for everyday items
- Non-slip mats for the bathroom floor
- A walker or cane, if the surgeon has said to use one
None of this needs to be fancy. The goal is to remove small hazards that can turn into a fall during a week when balance and strength are already weaker.
Medicaid Programs by State
The state decides who qualifies for each program below, after its own review. We don't decide this, and no other agency does either. What we can do is help a family find out if they may be a good fit, and help with the application.
New York
Medicaid covers home care for people who meet the state's rules. Eligibility and sign-up go through New York's Medicaid program directly.
New Jersey
New Jersey Medicaid, including its Managed Long-Term Services and Supports (MLTSS) program, sets up long-term home care for members who qualify.
Maryland
- Community First Choice (CFC): Lets a family member or close friend become a paid caregiver, once the Maryland Department of Health says yes.
- Community Options Waiver: For people who need more care hours than CFC gives.
- A participant's legal guardian or representative cannot be the paid caregiver.
Michigan
- Home Help Program: Adult children, siblings, other relatives, friends, or neighbors can become paid caregivers. Spouses and parents of young children cannot.
- Caregivers must be 18 or older, pass a background check, and sign up in the state's CHAMPS system.
- An MDHHS caseworker decides who qualifies after visiting the home.
Connecticut
- Adult Family Living: The caregiver must live in the same home as the client.
- Spouses cannot be paid caregivers in this program.
- The Department of Social Services decides who qualifies.
What Home Care Actually Costs
Quick Answer
Private-pay, non-medical home care costs about $30 to $33 an hour across New York, New Jersey, Maryland, Michigan, and Connecticut as of 2026. This is based on several 2026 industry cost surveys. It costs more in big cities like New York City, and more still for skilled nursing visits. (Numbers are current as of 2026 and change by agency and place. Call for a number that fits your case.)
Here is the cost by state for normal non-medical personal care. This uses 2026 industry rate data:
| State |
Typical Hourly Rate |
Typical Full-Time Monthly Cost (~44 hrs/week) |
| New York |
~$32-$33/hr (NYC often higher) |
~$6,100-$6,300 |
| New Jersey |
~$33/hr |
~$5,500-$5,800 |
| Maryland |
~$30/hr |
~$5,100-$5,300 |
| Michigan |
~$30/hr |
~$5,400-$5,500 |
| Connecticut |
~$30/hr |
~$5,700-$5,800 |
Skilled nursing visits cost more than non-medical care. This is because they need an LPN or RN. Industry rates usually run $50 to $70 an hour for an LPN. For an RN, rates run $85 to $110 an hour or more. The exact rate depends on how complex the care is, and where you live.
A few things that change the total cost:
- Hourly care is billed per visit, usually with a set minimum number of hours. This works well for covering certain parts of the day.
- Live-in care uses one caregiver who stays overnight, usually at a flat daily rate, which costs less per hour than round-the-clock shifts.
- 24/7 shift care uses more than one caregiver, working in shifts through the day and night. This is the most costly option, but it is often needed for higher-need recoveries.
We offer schedules across all of these types. This ranges from a few hours a week to full 24/7 live-in care. We're glad to give you a real number for your case on a call. You won't have to guess from a general range.
Mistakes Families Make When Arranging Post-Surgery Care
Quick Answer
Families often make a few common mistakes. They wait until discharge day to arrange care. They don't know how much help the first week takes. They think insurance covers everything. They don't get the home ready ahead of time. None of these mean a family did something wrong. They are just easy to avoid once you know to look out for them.
Mistake 1: Waiting Until Discharge Day to Start Looking for Care
Hospitals often send patients home faster than families expect. Sometimes it's the same day, for simple outpatient surgery. Start calling agencies before surgery. Do this even before you know exactly how much help you'll need. This way, you get to pick from real options. If you wait, you're stuck with whoever happens to be free that day.
Mistake 2: Not Knowing How Hard the First Week Will Be
The first few days home are usually the hardest, even after a small procedure. Pain is at its worst. Movement is at its most limited. The patient is often still adjusting to medicine. Families often plan for "just a few hours here and there," then learn fast that it's not enough.
Mistake 3: Thinking Insurance Covers More Than It Does
Medicare's home coverage is smaller than most people think. It doesn't cover the daily personal care that most recoveries actually need. Find out what is covered, and what isn't. Do this before you're deep in recovery. It helps you avoid a bad surprise.
Mistake 4: Not Getting the Home Ready
A rented walker doesn't help much if there's a rug it can catch on, or if the bathroom has nothing to hold onto. Simple prep, like clearing hazards, setting up a recovery space on the main floor, and putting up grab bars, makes a real difference in stopping falls.
When to call a doctor or get more help than home care can give: Watch for a few warning signs. These include a fever, redness or fluid from the incision, sudden confusion, chest pain, or trouble breathing. Home care alone should not handle these. Call the surgeon or get emergency help right away.
Is your family trying to decide between starting care now or waiting to see how the first few days go? A home visit can help answer that. We'll look at the real recovery plan. Then we'll tell you what level of help makes sense, before you commit to anything.
Your Step-by-Step Checklist to Set Up Home Care After Surgery
Quick Answer
Start before surgery, not after. Talk to the discharge planner. Get a home safety check. Find out what insurance or Medicaid may cover. Pick the right kind of caregiver. Plan the first 72 hours.
- Talk to the discharge planner before surgery, if you can. They can tell you what kind of help the surgery team expects, and for how long.
- Get a home safety check. Look for tripping hazards, bathroom grab bars, and whether stairs will be a problem.
- Find out what's covered. Call your insurance company. If Medicaid might apply, start that talk with your state's program early.
- Pick the right kind of caregiver. A recovery with heavy wound care needs a skilled nurse. A recovery focused on moving around needs more personal care and physical therapy support.
- Plan the first 72 hours. Know who is picking the patient up, who is home that first night, and who is tracking medicine.
Documents to have ready:
- Discharge paperwork and medication list
- Insurance card and/or Medicaid information
- Surgeon's contact information
- A list of current medications and known allergies
Questions to ask any home care provider:
- Are your caregivers watched over by an RN or LPN for skilled needs?
- What happens if our regular caregiver is sick or can't come?
- How fast can care actually start?
- Do you take Medicaid, and can you help us find out if we may qualify?
Frequently Asked Questions
Does Medicare cover home care after surgery?+
Not by itself. Medicare can cover skilled home health visits, like nursing or physical therapy. A doctor must order them. The patient must also stay home to recover. Medicare usually doesn't cover non-medical help with daily things like bathing or meals.
Does Medicaid cover home care after surgery?+
It can, depending on your state. It also depends on your own money and health situation. New York, New Jersey, Maryland, Michigan, and Connecticut all run Medicaid home care programs. But each state decides who qualifies, after its own review.
How soon can I begin using in-home care services after surgery?+
In many cases, care can start within 24 to 48 hours after the patient leaves the hospital, once the first visit is done. We're glad to work directly with a hospital discharge planner to make that move easier. Timing depends on the level of care needed and who is free to help in your area. It helps to call as soon as a surgery date is set.
What's the difference between home care and home health care?+
Home care is non-medical daily help: bathing, dressing, meals, and company. Home health care is clinical care from nurses or therapists. It covers wound care, medicine management, and physical therapy.
How long will I need in-home care after surgery?+
It can be just a few days for a small outpatient surgery, or several months for a joint replacement or cardiac surgery. The care plan is usually checked again as recovery goes on. It isn't fixed from day one.
Will Medicare pay for home care after a hip or knee replacement?+
Medicare may pay for physical therapy visits if a doctor orders them. Help with daily tasks, like bathing, dressing, and meals, is usually private pay. In some cases, Medicaid pays for it, for those who qualify.
What is home care like after pacemaker surgery?+
Recovery is usually shorter and easier than open-heart surgery. But it still needs care. This means managing medicine, like blood thinners. It also means following activity limits for the first few weeks. Watch the incision site for infection too. Always follow your cardiologist's rules. They can be different for each patient.
Can a family member get paid to provide post-surgery care?+
In some states, through certain programs, yes. Michigan's Home Help program lets some family members become paid caregivers. So does Maryland's Community First Choice program. A spouse usually can't in Michigan. Each state decides who qualifies.
What does home care cost after surgery?+
Non-medical home care costs about $30 to $33 an hour across our five states as of 2026. Skilled nursing visits cost more. See the cost section above for state numbers, and how live-in, hourly, and 24/7 schedules change the total.
Can I get home help after surgery even without Medicaid or Medicare covering it?+
Yes. Private pay is the most common way families cover non-medical home care when insurance doesn't apply. It works this way. Scheduling can range from a few hours a week to full-time.
Is home care covered by insurance in New York, New Jersey, Maryland, Michigan, or Connecticut?+
It depends on the type of insurance. It also depends on the type of care. Medicare may cover skilled home health visits. Private insurance and long-term care insurance plans differ. Medicaid may cover non-medical care too, for those who qualify under each state's program.
How do I choose a home care provider after surgery?+
Look for CHAP or a similar accreditation. Ask if nursing oversight is included. Check that they serve your area and can give the kind of care your surgery needs. Ask how fast they can actually start.
Getting Home Care Started
Planning matters more than most families expect, until they are in the middle of it. Knowing the difference between home care, home health care, and a rehab stay helps. So does knowing what Medicare and Medicaid will and won't pay for. Having a plan before discharge day makes the biggest difference in how the first weeks go.
Cottage Home Care has served families in New York, New Jersey, Maryland, Michigan, and Connecticut since 2019. We offer CHAP-accredited home health aide support. We also offer personal care and skilled nursing. Our RN and LPN staff oversee all of it. Call 516-367-2266 if you're arranging care for yourself or a family member. You can also reach out through our contact page to set up a home visit. We can help you find out if you may qualify for Medicaid-funded support in your state.
Related reading: After-Hospital Care in New York · Home Care in Baltimore, MD · Home Care Services in Jersey City · Home Care Packages Explained
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Alex TullaoRegistered Nurse
