Will Medicare Pay For A Caregiver?

If you only need custodial care, Medicare will not pay for a caregiver. Medicare can pay for home health services for a short term if you meet certain qualifications and have a specific, regularly-reviewed care plan from your doctor.

Medicare Covers Home Health Services

You may be able to receive in-home medical care from a Medicare-certified home health agency if you meet the qualifications. Home health services can include part-time or intermittent skilled nursing care, physical therapy, occupational therapy, or speech-language pathology services. 

Medicare Part A will cover home health care after you have been a hospital inpatient for at least three days, not counting the day of your discharge. If you will start to receive home health care within 14 days of leaving the hospital, Medicare will cover you for 100 days. You owe a daily coinsurance after 20 days of care for each benefit period.

Medicare Part B may cover home health services without a qualifying hospital stay if your doctor says they are medically necessary. You must also visit your doctor in person 90 days before treatment or within 30 days after you begin to receive home health services. Your doctor will need to develop a care plan that specifies the type of healthcare professional who should provide the services you need, how often you need the services, what results they are expecting, and what medical equipment is needed for your care. This plan will be recertified every 60 days.

You may also have the help of a home health aide if you are receiving additional skilled medical care. Home health aides can assist with monitoring your vitals, checking that you are taking your medications and eating well, and making sure you live in a safe environment. Medicare may also cover medical social services if you are already receiving skilled medical care.

Medicare and Custodial Care

Custodial care is the term for assistance with the activities of daily living, such as bathing, getting dressed, feeding yourself, and using the restroom. Medicare will not cover these services if they are the only services you need, and Medicare does not cover 24-hour care.

If you need a caregiver but Medicare will not pay for one, you can apply for a waiver program through your state. All states provide assistance programs to help people afford these and similar services. Many people who need long term care will qualify for Medicaid after paying for these services for a while. Medicaid helps to pay for long term care, and can help with some of these costs.

The agents with Magellan Healthcare can help you find affordable coverage to make your money go further. Contact us today to book an appointment.