Private health insurers, like Humana, offer Medicare Advantage plans that can provide Part A and Part B benefits, in addition to a variety of additional benefits. Humana also offers Medigap supplemental plans and prescription drug coverage (Part D) for individuals with original Medicare. Plans offered by Humana and other insurance carriers may help some Medicare recipients save on the costs associated with home health care services.
Understanding Home Health Care Services
Agencies that offer home health care may list several services they provide even if they are not covered by Original Medicare, a Medicare Advantage plan, or supplemental Medicare coverage.
The range of services can include:
- Skilled nursing assistance
- Medication management and wound care
- Physical or occupational therapy
- Speech-language therapy
- Medical-related social services
- Home health aide care
- Meal deliveries
- Help with household chores
- Help with daily living activities and personal care
- Medical supply delivery
- Medical equipment provision
No matter what agency you choose for these services, they should be in contact with your team of health care professionals in order to understand all your needs. They should also be able to provide you with detailed information about what your Medicare coverage includes and what you may be expected to pay for out of pocket.
Agencies that offer these services can give recipients a document known as an Advance Beneficiary Notice (ABN) before providing supplies or services not covered by Medicare insurance. If you are not offered this document, you may find it beneficial to ask for it before accepting any treatment plan.
Medicare Requirements for Home Health Care Services
Medicare Part A and Part B sets certain standards that recipients must meet in order to be eligible for home health care. First, a beneficiary must be under a doctor’s care and receiving care according to a plan that the doctor creates and regularly reviews.
The doctor must also certify that you are in need of one or more of the following services:
- Physical therapy
- Speech-language pathology
- Occupational therapy
Therapists must be certified by Medicare, and the treatment may be limited in scope to a plan that is considered safe and effective and targets a specific condition. Medicare may also require that the plan shows a reasonable expectation regarding measurable improvements and the length of time required for treatment to be completed.
Additionally, a doctor must certify that the recipient is homebound and that they do not need full-time or permanent skilled nursing care. Homebound recipients may still be allowed to leave their home to receive other medical care and take part in some non-medical activities, such as faith-based services and respite or adult day care.
Humana Medicare Coverage for Home Health Care
Humana’s Medicare insurance options, such as their Medicare Advantage, Medicare Supplement and stand-alone prescription drug plans, may only be available in certain states. All Medicare Advantage plans will provide recipients the same services that Original Medicare covers, but some plans may offer recipients additional benefits, such as meal delivery or home health care services not already covered by Medicare. Your location may impact which Medicare Advantage plan Humana can offer you.
Medicare Supplement plans are standardized across all carriers and aim to reduce the costs associated with certain deductibles, coinsurances and co-payments for Part A and Part B rather than offer additional services. While their benefits do not directly impact what services a recipient can use for home health care, they may help cover cost-sharing obligations for the services Original Medicare offers. The Medigap plans that Humana offers may not be available in every location.
Dual-eligibles who receive Medicare and Medicaid benefits may also be able to choose Humana’s Medicaid plan if they live in an area where Humana provides it. Each state manages their long-term care services differently, but these beneficiaries may be eligible to receive expanded home health care services if they meet their state’s requirements for care needs.