The comforts of home can mean different things to different people. It may include sleeping in your own bed, curling up in your favorite chair, or enjoying a view of your garden from the kitchen window. When you are recovering from an illness or injury, your own home may provide the best environment to help you heal. If your doctor recommends it and you meet the criteria, your in-home health services may be covered by your Medicare insurance.
Home health care may be the best solution to your needs. Home health services can be just as effective as treatment you would receive in a hospital or skilled nursing facility and may be less expensive. The wide range of services can include:
- Coordination of care with your medical providers
- Monitoring serious illness
- Check vitals, including blood pressure, temperature, heart rate, and breathing
- Wound care
- Administer intravenous medication or nutritional therapy
- Provide injections of mediations
- Patient and caregiver education
- Medical supplies for use in the home, such as durable medical equipment (DME)
In-home care should be ordered by your physician to help you recover from an illness or injury, regain your independence and self-sufficiency, maintain or improve your condition, and/or slow any progressive decline.
Medicare Can Help Pay for Home Health Services
Medicare Part A (Hospital Insurance) and/or Part B (Medical Insurance) will help cover the costs of in-home health services if you are being treated by a doctor who creates a plan of care and reviews it regularly. Your doctor must certify that you require one of these services:
- Intermittent skilled nursing care, defined by Medicare as less than 7 days per week or less than 8 hours each day over a period of 21 days or less
- Physical therapy, speech language pathology, or occupational therapy
You must be homebound and your condition should be expected to improve within a reasonable amount of time. The home health agency must be approved by Medicare. If you have Original Medicare, you will pay nothing for covered home health visits. If you need Medicare-covered medical equipment, you will likely pay 20% of the Medicare-approved amount. The Part B deductible will apply.
Many Medicare recipients find that although Original Medicare covers many costs, they need supplemental insurance to help cover some of their out-of-pocket expenses. Medigap, or Medicare Supplement, policies help pay deductibles, copayments, and coinsurance. If you have a Medigap policy, let your doctors know in advance so they can help coordinate billing.
If you are enrolled in a Medicare Advantage plan, you will have at least the same benefits as Original Medicare, but some MA plans offer additional coverage for home health services. You may need to get care from a home health agency that contracts with your plan and certain restrictions or costs may apply. Contact your plan directly to find out your exact costs.