Does Medicare Cover Home Health Care? What You Need To Know

In the realm of home care services, there is a distinction between medically necessary services and untrained caregiver services. Identifying which individuals are eligible to receive Medicare-covered in-home care requires understanding the differences between these two levels of care.

Does Medicare Cover Home Health Care?

The Medicare program covers only home health care provided by skilled professionals under prescription by a doctor. However, there are some requirements that patients must meet.

Who Can Receive Medicare-covered Home Care?

To qualify as a Medicare beneficiary, individuals must be covered by Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance), along with meeting the following criteria:

The recipient must be under a doctor’s care. Medically necessary services must be included in a doctor’s plan of care to treat or maintain a health problem. Since this care is not long-term, the doctor must recertify it every 60 days.

A doctor must certify the recipient is homebound to qualify. This means that leaving home involves a considerable effort because the person relies on a mobility aid (such as a cane, wheelchair, or walker), special transportation, or outside assistance. Certainly, homebound status is not dependent on a person being bedridden. It can still apply even if the person can leave home for medical treatments, adult daycare, and small, infrequent outings other than medical, like religious services and family gatherings.

At least one of the following services must be certified by a physician as necessary to be eligible for assistance: Intermittent skilled nursing or skilled therapy services such as physical therapy, speech-language pathology, and occupational therapy.

How long will Medicare pay for home health care?

AARP states that in order to qualify for Medicare coverage, a doctor must order the services, and one of the more than 11,000 Medicare-certified home health agencies has to provide the care. A Medicare beneficiary can receive home health care for up to 60 days at a time if these conditions apply.

Medicare For Elderly Care at Home

Medicare Insurance Advisors (MIA) is a comprehensive broker and offers the insurance products of numerous companies.

Medicare does pay for some services at home. If you have questions about qualifying, or you or someone you know needs home health care, please contact us. We can help you through the process of eligibility and securing in-home health care for you or your loved one.