Is Home Health Care Covered by Medicare?
Home health care may provide essential assistance with daily activities like bathing, dressing and going to the bathroom. Medicare offers assistance – provided certain criteria are met – when it comes to these areas.
To qualify for Medicare home health coverage, a Medicare-approved doctor must prescribe services and certify that you are “homebound,” meaning leaving your home requires considerable effort or using aids such as walkers or wheelchairs. Your physician and home health agency must then create a plan of care outlining when services will occur and their duration while outlining anticipated results based on what your physician anticipates; your plan must then be reviewed every 60 days for certification by your physician.
Medicare Part A covers home health care after an extended hospital stay or stay in an SNF, provided it meets certain conditions. Medicare Part B covers physical therapy and occupational therapy costs, while Medicare pays up to 80% of its approved amount for durable medical equipment such as wheelchairs or walkers prescribed by your physician that you use at home – up to 15% more if the home health agency you select doesn’t accept assignment from Medicare.
Medicare Part A covers not only traditional services such as skilled nursing or therapy, but can also cover social work services ordered by your physician – counseling and assistance with finding resources in your community may fall within this umbrella. Medicare Part B pays for limited home health aide services on an intermittent basis when prescribed by a doctor – however this will only apply when needed to support skilled nursing or therapy services being provided – Medicare Part A does not cover custodial care costs.
If you want to avoid costly gaps in your Medicare coverage, purchasing a Medigap policy can help fill some of those holes with benefits such as hospitalization coverage and travel reimbursement benefits as well as prescription drug coverage. With Blueprint for Medicare’s free tool you can compare plans from top-rated insurers.