Recovery at home can be more comfortable and less costly than a lengthy hospital stay. Home health care can be a good solution for those patients who need care for recovery after an injury, monitoring after a serious illness or health complication, or medical care for other acute health issues. Medicare recipients may get help paying for home health care if you meet specific criteria.
What is Home Health Care?
Home health care covers a wide range of treatment options that are performed by medical professionals at home. Care may include injections, tube feedings, condition observation, catheter changing, and wound care. Skilled therapy services are also included in home health care, and these include occupational, speech, and physical therapy services that are necessary to treat your specific illness or injury. Occupational therapy aims to increase daily functionality in regular activities, such as eating or changing clothes. Speech-language pathology can improve language and speech skills, and physical therapy can help you get back on your feet and may include walking, improving mobility, and and increasing strength.
Medical social services may also be covered under your Medicare benefits. These include counseling services and can provide community resources to address social and emotional distresses.
Home Health Care Coverage Options for Medicare Recipients
Home health services may be covered by Medicare insurance, but there are a few conditions that must be met in order for Medicare to cover your costs, including the following:
- You must be certified homebound by your physician.
- You must require skilled nursing services intermittently. Skilled nursing care includes treatments that require specific knowledge and training to administer or complete. Treatments must be needed part time, at least once every 60 days, but not more than once daily for up to three weeks.
- You must be under the care of a physician. You must meet directly with a doctor during the three months before you begin home health care or no more than a month after it has been initiated. Your physician must outline a plan of care for you, and you must regularly meet with them to note progress and assess any changes in your overall health.
If you require full-time care, other options besides home health care need to be explored.
How Much Will You Pay For Home Health Care?
If you do qualify for home health care, Medicare Part A and Part B may help cover the costs associated with your care. You will pay $0 for home health care services. If you require durable medical equipment, or DME, Medicare benefits will help pay for equipment you may need, including items that are designed for medical use in the home and serve a specific medical purpose, including wheelchairs, oxygen equipment, or hospital beds.
Medicare Part B will cover 80 percent of the Medicare-approved amount for DME as long as the equipment is ordered by your physician and you rent or purchase the devices through a supplier that is participating in Medicare and accepts assignment. You will be required to pay 20 percent out of pocket, and the part B deductible may apply. If you are enrolled in a Medicare Advantage (MA) plan, you will have the same benefits as Original Medicare Part A and Part B, but many MA plans offer additional coverage.