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Is home care covered by Medicare

Trained wise doctor entertaining her patient

Does Medicare cover home health care?

If you’re taking care of an older parent, it is only natural to ask yourself whether or not Medicare covers home care health. But since we are here to help you, we shared in this article everything you need to know about determining who can benefit from Medicare-covered in-home services.

Who benefits from home care covered by Medicare?

The first thing you need to know is Medicare covers the home health care services prescribed by a medical practitioner and offered by a trained caregiver. 
Your loved one needs to meet the following criteria:

  • He must be under the care of a doctor who created a plan of treatment and care based on home services. Every 60-days, this plan needs to be re-certified.
  • He must have serious issues moving around, which leads to reliance on mobility aid. This can include a walker, cane, or wheelchair. But at the same time, if the patient needs the assistance of another person to move around, it can be deemed eligible for the coverage.
  • His doctor must clearly indicate the necessity of either intermittent skilled nursing care or specialized therapy services.
  • An agency certified by Medicare must offer home care services.

What services are covered by Medicare?

Now that you know how your loved one can become eligible for Medicare coverage, let’s take a look at some services he can benefit from:

  • Health and vital signs monitoring
  • Wound care resulted from a surgical incision
  • Intravenous drugs administration
  • Nutrition therapy
  • Catheter changes
  • Caregiver and patient education
  • Physical therapy
  • Occupational therapy
  • Speech-language therapy

Remember that Medicare covers the services listed above only if they are considered necessary treatments or maintenance approaches for a patient’s condition. Also, Medicare views home health care as a way to delay placement in an assisted living or professional nursing facility, not to replace those institutions entirely.

Are unskilled home care services covered?

Medicare won’t cover for unskilled home care if those are the only services required by a patient. Both homemakers and personal home care services will be covered if they are part of the detailed care plan created by a licensed medical practitioner.

How much does it cost out of the pocket?

Original Medicare Coverage (Part A & B) will cover only the ordered home care services recommended by a doctor. Also, these must be offered by a certified home health organization. Extra services not mentioned in the senior’s health care plan won’t be covered, and you will have to pay for it.

The bottom line

The idea here is that you need to discuss with your parent’s doctor about the required home care services. If he underlines the fact that those are necessary based on health issue grounds, a certified home care health plan will deem your senior eligible for Medicare coverage. 
You should know that in most situations, such services are only partially covered by Medicare. And this happens since your parent might require additional help with daily tasks, health monitoring, or nutrition.

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