You probably have many questions when it comes to Medicare. What plan is best for you? When do you apply? What do the different Medicare Parts mean? What benefits am I eligible for?
One question you might not have in mind at the beginning of the process, but might come up in the future, is whether not your Medicare plan will cover home healthcare.
Does Medicare cover care in the home?
To be eligible for Medicare home health benefits, you must be:
- Homebound. Essentially, you must be unable to leave your home without considerable effort or support of another person or a device (such as a wheelchair).
- Certified by a doctor or medical professional. This expert must declare that you need intermittent care. This means you need care at least once every 60 days and at most once a day for up to three weeks. Keep in mind this period can go longer if needed. Skilled therapy refers to occupational therapy, physical therapy, skilled nursing care and/or speech-language therapy.
- Under a plan of care. You must meet face-to-face with a doctor within the 90 days before you start home healthcare. The plan should include what services you need and how often, who will provide them, what supplies are required and what results the doctor expects.
- Approved. Medicare has approved the home health agency caring for you.
Medicare does not cover:
- 24-hour care at home
- Custodial or personal care when this is the only home care you need
- Household services such as shopping, cleaning and laundry when they are not related to your care plan
- Meal delivery to your home
Who is Eligible for home healthcare?
All people with Part A and/or Part B who meet the appropriate conditions will be eligible:
- You are under the care of a doctor and getting a plan of care created and reviewed regularly by a doctor.
- You must need, and a doctor must certify that you need, one or more of the following:
- Intermittent skilled nursing care
- Physical therapy, speech-language pathology, or continued occupational therapy services.* (A lot of restrictions/circumstances apply here so be sure to look over your plan details).
- You must be homebound, and a doctor must certify that you are.=
You’re not eligible for the home health benefit if you need more than part-time or “intermittent” skilled nursing care. If you are interested in discovering if you qualify for more Medicare benefits, call us today or take our quiz.