Yes! Medicare covers eligible home health services under Medicare Part A and Part B.
What Home Health Services Does Medicare Cover?
Medicare will cover part-time skilled nursing care, physical therapy, occupational therapy, speech language pathology services, medical social services, injectable osteoporosis drugs, durable medical equipment, medical supplies for home use, and part-time home health aide care received while also receiving other nursing or therapy care.
Note that these are not long-term solutions. Medicare does not cover 24-hour home health care. It also does not pay for meals delivered; shopping, cleaning, laundry, and other homemaker services; and custodial or personal care for the activities of daily living. The activities of daily living are simple essential functions such as bathing and feeding yourself. When you have difficulties with more than a few of those activities, you become a good candidate for long term care, which is also not covered by Medicare.
Eligibility for Home Health Care Coverage
Medicare will cover these home health care services, but only if you meet certain eligibility criteria. You have to be under a doctor’s care and must be receiving services according to the plan of care your doctor creates, which they must review regularly. Your doctor must also certify that you are homebound and need intermittent skilled nursing care or physical therapy, speech-language pathology or continued occupational therapy services. The latter category of services is covered when your treatment is specific, safe, and effective for your condition; the amount, frequency and time period of the services has to be reasonable; and the services require the skill of a qualified therapist. Your condition must also either be expected to improve or you need a skilled therapist to make a maintenance program or you need a skilled therapist to do maintenance therapy for your condition.
Medicare will only cover part-time, or intermittent, home health care services. You can attend adult day care and still be eligible, and you can have short, infrequent absences.
Home Health Care Costs
Home health agencies will help you understand your costs based on Medicare’s coverage and the price of any services you will have to pay for yourself. For home health care services covered by Medicare, you will pay $0, but any durable medical equipment will cost 20% of the Medicare-approved amount once you meet the Medicare Part B deductible.
Part-time home health services are covered by Medicare if you meet the eligibility criteria. Medicare coverage can be overly technical. Magellan Healthcare is here to help you wade through the bullet points and understand your benefits. When you have questions about your Medicare plan, speak to one of our Medicare experts.
