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. Home health care services covered by Medicare include skilled nursing care, physical therapy, occupational therapy, and speech-language pathology services when medically necessary. Intermittent or part-time home care is only covered if you also receive skilled nursing care, physical therapy, speech-language pathology services, or occupational therapy at the same time. To qualify, your loved one must first meet the eligibility criteria for home health care covered by Medicare.
If a family member needs help finding home care, A Place for Mom's senior housing counselors will discuss the options in your loved one's area that best fit their needs. You're generally not eligible for Medicare home health benefits if you need full-time skilled nursing care for an extended period of time. Home health care agencies must provide an advance notice of lack of coverage (ABN) to the beneficiary before providing services or supplies that Medicare is unlikely to cover. This means that when Medicare covers skilled nursing visits, therapy services and home health care, families don't have to pay co-pays or coinsurance.
for these services. Create realistic budgets that take into account both the services covered by Medicare and the home care expenses you'll pay privately. Medicare covers home health care services that are considered reasonable and necessary for the treatment of an illness or injury. If you're enrolled in original Medicare or Medicare Advantage, you don't pay anything for home health care services.
Dual-Eligible Special Needs Plans (D-SNP) are specialized Medicare Advantage plans that combine all the benefits of Medicare and Medicaid in an easy-to-manage plan that offers coordinated home care services. TheKey understands the complexities of Medicare home care coverage and works with families to manage these benefits while providing comprehensive home care services for the elderly. Medicare pays for home health care for eligible, homebound older people who require essential medical services for the treatment of an illness or injury. Medicare doesn't cover custody or personal care services when they are the only care needed, such as 24-hour home care, housekeeping services, food delivery, transportation to medical appointments, or complementary care services.
Be aware of potential changes in care needs over time, as many older people start with specialized care covered primarily by Medicare, but then need more care services in custody. After this date, most telehealth services will require beneficiaries to be in an office or medical facility in a rural area, with important exceptions for mental and behavioral health services, which can be accessed from home. Medicaid also provides long-term care services that Medicare doesn't cover, such as personal care assistance, homemaking services, and adult day programs that help older people stay home.
