IHSS stands for In-Home Supportive Services. It is a publicly funded program that helps pay for care at home for those who are eligible. IHSS recipients must be 65 years or older, blind, or disabled and in need of assistance in order to remain at home. IHSS care may take the place of care in a skilled nursing, or assisted living facility.
Eligibility for Home Health Services
Eligibility for IHSS requires that you are a resident of the state of California and have a MediCal eligibility determination, you live in your own home, and you have completed a required health certification form.
For Medicare recipients who live in other states of the United States, Medicare benefits cover similar home health services for those who meet the requirements for eligibility. If you, or someone you are caring for, would like more information about home health services provided by Medicare, here are some of the facts.
What Are Home Health Care Services?
If you are eligible for IHSS in California, you have coverage for common daily activities which you may find difficult with your disability. Your needs are assessed by a professional and services offered include the following:
• Household chores that include meal preparation and clean up, grocery shopping, and
light house cleaning
• Transportation to and from medical appointments
• Spoon feeding
• Personal care needs such as toileting, bathing, hygiene care, nail and hair care,
and assistance with dressing
• Help with medical equipment
• Medication management
For home health care services covered by Medicare, if you have had an illness or injury, a home health care agency provides skilled care to assist you as you get well. Some of the services they provide may include:
• Wound care
• Education for patient and caregiver involving equipment use, care instructions,
• Intravenous or nutrition therapy
• Checking the illness or injury progression, what you are eating and drinking, your
vital signs, whether you are taking medications, if you have pain, the safety of
• Coordination of your care between you and your primary health care provider
If you are recovering from an injury or illness that requires skilled health care assistance, you may qualify for Medicare’s home health care services or IHSS in California. Being able to recuperate at home is not only cost effective, it is more convenient and comforting for you and your caregiver.
Medicare Benefits for Home Health Services
If you have either Original Medicare Part A (hospital insurance) and/or Part B (medical insurance), you have coverage for certain, physician-ordered, home health services that are provided by a home health care agency. These services may include the following:
• Intermittent or part-time skilled nursing care
• Physical, speech-language, and/or occupational therapy
• Medical social services
• Intermittent or part-time personal hands-on care
Home health care services that are not included in Medicare coverage are:
• Around the clock care at home
• Meals or meal delivery services
• Homemaker services such as cooking or cleaning
• Custodial care if it is the only care you require and includes bathing,
dressing, or using the facilities
You may be eligible for Medicare coverage of home health services if you have Medicare benefits through either Part A and/or Part B and you meet the following:
• You are under a physician’s care at the time. The physician must create the care
plan and review it regularly.
• Your health care provider certifies that the care you need is either intermittent
skilled nursing care, physical, occupational, or speech-language therapy, and the
frequency of these services is reasonable, safe, specific, and are effective
treatments for your condition.
• Your health care provider certifies that you are homebound and that the services
you require are only intermittent or part-time.
Together with the services that an agency provides, Medicare Part B recipients are also covered for medical equipment and supplies used at home. This includes durable medical equipment or injectable osteoporosis drugs. You pay $0.00 for your home health care services and 20 percent for durable medical equipment. Medicare pays for 80 percent of the Medicare-approved final amount of durable medical equipment.
Does Medicare Cover In-Home Caregivers?(Opens in a new browser tab)
Does Medicare Cover Home Health Care? (Opens in a new browser tab)