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Seasider, you'll have to pay out of pocket for general cleaning, either through Private Duty service or by hiring a cleaning service. Depending on the extent of cleaning needed, the latter might even be cheaper. You might get an estimate from a cleaning service, work out with the rep how many hours would be needed, then get an estimate from a PD company. For that, expect to pay anywhere from $19 to $26 per hour, depending on your area.

Some people find someone to do the cleaning w/o going through any agencies, but you need to be aware of the pitfalls of hiring someone and paying directly, without addressing the issue of liability insurance.
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Medicare is for medical insurance only.
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No, not to my knowledge. Some HH(home health) agencies have aids who will provide minimal assistance to their patients such as cleaning their personal space. Changing sheets, cleaning their bathroom, heating a meal IF they are seeing the patient for a doctor ordered issue. Medicaid offers household assistance in some states (maybe all?) but not Medicare. My mom had HH through medicare for years. Her aid bathed her, shampooed, changed her sheets, took out her garbage, started her washer. My aunt has an aid twice a week through HH and she does about the same. Big help but the patient still needs someone else to clean the house
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