Not all Medicare-covered treatments have to take place at a hospital or doctor’s office. In some instances, Medicare will provide coverage for care you receive in your own home. However, there are specific requirements based on what you need, the nature of your condition, and the duration of home health treatments.
What Parts Of Medicare Do I Need For Home Health Care?
You will need Medicare Part A and/or Part B in order to get coverage for home health care. Part A covers inpatient treatments, whereas Part B covers outpatient treatments as well as medical equipment.
Where Do I Get Home Health Services From?
Home health care is provided by home health agencies. If you want coverage, you’ll need to get care from an agency that has a contract with Medicare. A home health agency should provide verbal and written information about what your care will entail, the costs covered by Medicare, and any services or items not covered by Medicare. A home health agency should issue an Advance Beneficiary Notice (ABN) prior to giving non-covered supplies and/or services.
How Do I Qualify For Home Health Care Coverage?
You qualify for home health care if you’re considered homebound, which means you:
- Have an illness or injury that makes it difficult or unsafe to leave your home
- Are unable to leave your home without some form of assistance, such as from a wheelchair, walker, crutches, or another person
- Are typically unable to leave your home
When Will Medicare Cover Home Health Services?
Medicare covers home health care as long as you’re temporarily in need of part-time or intermittent skilled medical services. This treatment plan must be created and reviewed by your doctor, who certifies that your illness or injury requires skilled nursing (aside from blood drawing), continued occupational therapy, speech-language pathology services, and/or physical therapy.
The condition you’re treated for must be expected to improve within a reasonable and predictable timeframe. You must require the help of a skilled therapist for creating a maintenance program, and you must need maintenance therapy from a skilled therapist for managing your condition.
What Home Health Services Will Medicare Cover?
Medicare covers services as long as they’re strictly for treating and managing your condition. Covered services include:
- Physical therapy
- Occupational therapy
- Medical social services
- Part-time/intermittent home health aide care (as long as you’re getting skilled nursing at the same time)
- Durable medical equipment
- Injectable osteoporosis medications for women
What Home Health Services Will Medicare NOT Cover?
Medicare won’t cover 24-hour care, meals delivered to your home, custodial or personal care (assistance with daily activities such as bathing and dressing), or homemaker services that aren’t relevant to your care plan.
How Much Will Home Health Care Cost With Medicare?
With Original Medicare (Part A and Part B), you won’t have to pay anything for home health services that Medicare covers. As for medical equipment covered under Medicare, you’ll pay 20% of the Medicare-Approved Amount after meeting your Part B deductible.
Get The Coverage You Need
No matter the circumstance, at JA Agency, we’ll give you the best policy because you deserve to have the Medicare coverage that makes your medical care more affordable than before. To learn more, call us today at (551) 795-1229.