Does Medicare Cover Home Health Care?

does medicare cover home health care

Home health care refers to any range of healthcare services delivered directly into the home environment to treat illness or injuries, including physical therapy, occupational therapy and speech-language pathology services. Medicare Part A and Part B both cover some or all of this care if certain criteria are met.

First and foremost, to qualify as homebound you must first be certified as such by your doctor. This means you’re unable to leave your house without exerting physical effort or using aids like wheelchairs, walkers, crutches etc. Additionally, they must review your home health care regularly and approve that intermittent services such as physical or occupational therapy might be needed for example.

Medicare requires that home health services come from providers approved by them, to ensure you’re receiving the highest possible standard of care. Although nonparticipating providers may still offer their services, this increases your risk of paying more. It would be ideal if they accepted Medicare’s payment which often amounts to lower monthly rates than their regular fees.

Medicare Part A can also assist in covering home health care if it becomes necessary as the result of hospital or skilled nursing facility stays or stays, typically beginning 100 days post discharge from either facility; however, you still must fulfill certain eligibility requirements in order to access this coverage.

Medicare typically pays for 80% of the costs for durable medical equipment used at home, such as wheelchairs or walkers, provided you meet your deductible. Not all home health agencies will carry such equipment, so you may have to order it from one specific provider.

Medicare does not cover long-term custodial care like traditional home health services do. Custodial care includes activities of daily living like bathing, dressing and eating as well as health related tasks like taking insulin or medications. Adult day or homemaker programs offered through state Medicaid plans or vouchers offered by private companies typically provide this care.

Some Medicare Advantage plans may provide custodial care, though most do not. If you require long-term assistance, other options exist such as assisted living or community-based services provided through your state Medicaid program. Furthermore, certain counties offer programs which offer non-medical custodial services like meal delivery or chore assistance that you should check with their respective local governments to learn about.

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