Does Medicare Cover Home Health Care?

Does Medicare Cover Home Health Care? – Overview

Home healthcare services are an option for homebound individuals due to medical conditions.

Home care providers offer a convenient, inexpensive and efficient way to care for your needs. Original Medicare’s Part A and Part B may cover the cost of home healthcare services if you are homebound and meet specific conditions.

Medicare does not cover non-medical in-home assistance with daily needs unless it is part of skilled nursing or therapy services prescribed by a doctor.

However, if you require coverage for long-term home care, you must know whether Medicare covers it.

Does Medicare pay for Home Caregivers?

The kind of home care you need, the reason you need it, and the duration of your need determine whether Medicare will pay for its expenses.

Here’s a look at aspects of homecare that are covered under the Medicare health insurance program:

For In-Home Medical Care

In case you are home-bound due to a serious illness or severe injury, then you are eligible for cost coverage under Medicare if you fulfill the following conditions:

Inability to leave home without a considerable and taxing effort. Home healthcare services are covered under Medicare.
The doctor has verified that you require home care and prescribes a plan for the care you need.
Medicare covers intermittent skilled nursing care defined as up to 8 hours per day and up to 28 hours per week (or, in some cases, up to 35 hours per week).
Medicare covers home health services that help maintain your current condition or prevent or slow further deterioration.
You require skilled physical, occupational, and speech therapists to help improve and maintain your existing state of health or to prevent it from worsening.
Home health aides are covered by Medicare only when you also need skilled care and only for part-time or intermittent services.
Need for a home healthcare agency that provides Medicare-approved and certified care.

What kinds of home care services are covered by Medicare?

Medicare covers several kinds of home care services. Some of the services and the Medicare eligibility to receive care are listed below:

Physiotherapy

If you need a physical therapist to provide you treatment in your home, then Medicare will likely pay for such services:

Condition assessment
Exercising and gait training as part of the recovery process after surgery, illness, injury or neurological problems, such as stroke
Post-surgical wound care
Wound care for lesions, burns and injuries

Occupational Therapy

In case you need occupational therapy at home, then you can expect Medicare to cover the cost of the following:

Establishing a daily regimen for medications, caring for personal needs and planning meals
Training to conserve energy and decrease stress
Learning to carry out daily tasks safely
Regaining functional abilities
Carrying out doctor’s orders

Speech Therapy

In case you require home care services of a speech therapist, then you can expect Medicare to cover the cost of:

Treatment to recognize and remember words
Treatment to help you recover your ability to swallow
Therapy to help you eat and drink normally
Learning about alternatives to communicate in case of speech impediment
Learning novel communication ways after suffering from loss of hearing

Nursing Care

In case a registered or licensed practical nurse needs to visit you at home for treatment, then you can expect Medicare to cover the cost of:

Changing wound dressings
Injecting medications
Changing catheter
Carrying out tube feedings
Administering IV medications
Educating you about taking care of drugs and of yourself

Homecare Aides

Medicare does not cover home care aides for monitoring vital signs; this is considered a skilled nursing function:

Monitoring your vital stats, including heart rate, body temperature and blood pressure
Ensuring you are taking medications as per the doctor’s instructions
Determining if your home is safe for you, as per your condition and needs
Checking to ensure that your diet and medications are on par with the doctor’s instructions

In-Home Custodial Care

Medicare does not cover caregivers who help with daily activities regardless of duration unless it’s part of skilled care that’s also being provided.

Medicare does not cover in-home custodial care services such as meal preparation, laundry, and general housekeeping. Custodial care only involving help with bathing, dressing, and using the restroom is also not covered unless it is part of skilled care prescribed by a doctor.

In essence, Medicare does not cover the cost of:

Round-the-clock care at home
Full-time skilled nurse services
Transportation

Conclusion

Medicare pays for home care services that are meant for short durations, such as helping people recover from severe injuries or serious illnesses.

This includes physical therapy, speech therapy, occupational therapy, skilled nursing and social services.

Grants for Medical

Medicare Home Health Care Coverage