Medicare covers part-time skilled nursing, wound care, patient education, physical therapy, occupational and speech therapy, and the care of a home health aide, if you are trained. Medicare pays for home health care for eligible, homebound older people who require essential medical services for the treatment of an illness or injury. A doctor or other medical professional must request home health care services and these must be provided by a Medicare-certified home health agency. Personal care services, such as help with activities of daily living (ADL), may also be covered if they are provided as part of a general plan that includes skilled nursing care.
To qualify, your loved one must first meet the eligibility criteria for home health care covered by Medicare. No, Medicare usually covers 100% of all approved home health care costs, but you may have to pay 20% of the amount approved by Medicare for any durable medical equipment. Sometimes, Medicare will pay for short-term custody care (100 days or less) if it's needed along with actual home health care prescribed by a doctor. Unlike Medicare, Medicaid covers long-term care in custody, including nursing home care and home and community services (HCBS).
Qualifying for home health care under Medicare may seem like a complex process, but it's fully manageable with the right information and resources. If you make sure you meet the eligibility criteria, choose a Medicare-approved home health agency, and understand your rights and responsibilities, you can access the care you need to maintain your health and well-being at home. You're generally not eligible for Medicare home health benefits if you need full-time skilled nursing care for an extended period of time. Before you start getting home health care, the home health agency must tell you how much Medicare will pay. The documents will also include a care plan that notifies Medicare and health care agencies about the services and equipment you'll need while you're being treated.
Medicare Parts A (hospital insurance) and B (health insurance) share responsibility for home health care coverage. However, Medicare home care benefits can cover personal care provided in conjunction with eligible home care services, such as transitional home care. Medicare covers home health care services that are considered reasonable and necessary for the treatment of an illness or injury.
