What home health services does Medicare cover?

Medicare covers a range of home health services under certain conditions. Here’s an overview of what is covered:

 

 1. Eligibility Requirements:

- Homebound Status: You must be considered homebound, meaning that leaving your home requires considerable effort and you are unable to do so without assistance.

- Medically Necessary: The services must be medically necessary and ordered by a doctor.

- Plan of Care: You need to have a written plan of care from a doctor that is periodically reviewed by your doctor.

 

 2. Covered Services:

- Skilled Nursing Care: Part-time or intermittent skilled nursing care provided by a registered nurse (RN) or licensed practical nurse (LPN) is covered.

- Physical Therapy: Services provided by a physical therapist to help with mobility, strength, and function.

- Occupational Therapy: Therapy to help with daily living activities, such as dressing, bathing, and cooking.

- Speech-Language Therapy: Services to help with communication or swallowing disorders.

- Home Health Aide Services: Assistance with personal care tasks such as bathing, dressing, and grooming, but only when provided in conjunction with skilled nursing or therapy services.

- Medical Supplies: Some medical supplies, such as wound dressings or catheters, may be covered if they are needed for a skilled nursing or therapy service.

- Durable Medical Equipment (DME): If necessary for your plan of care, Medicare covers some durable medical equipment used at home, like oxygen equipment or a walker.

 

 3. Not Covered:

- Custodial Care: Medicare does not cover non-skilled personal care services, such as help with routine daily activities if this is the only care you need.

- 24-Hour Care: Medicare does not cover 24-hour-a-day care, full-time home health aide services, or care in a facility.

- Meals or Housekeeping: Medicare does not cover meal delivery services or housekeeping.

 

 4. Cost:

- Home Health Care: Generally, you pay nothing for covered home health care services. However, you may be responsible for 20% of the Medicare-approved amount for durable medical equipment.

- Medicare Advantage Plans: If you are enrolled in a Medicare Advantage Plan (Part C), check with your plan for specific coverage details, as it might vary from Original Medicare.

 

Medicare’s home health coverage is designed to help individuals recover from illness or injury and to provide support for those with chronic conditions while remaining in their own homes.If you have specific concerns or questions, NevadaMedicare.Health is here to help with all your Medicare needs. Call 888-895-3267, email darinweidauer@ecos.care, or visit www.EcosMedicareSolutions.com.