In recent years, home health care has become an increasingly popular alternative for seniors recovering from illness or injury, and new home health care agencies continue to spring up. The main question that people ask when considering home health care is: will Medicare pay for it? The answer: it depends.
It’s a common misconception that Medicare provides coverage for long-term home health care. This is not the case. Medicare only covers home health care for a limited period of time, and then only if certain conditions are met. Despite the limits, the Medicare coverage that is available can still be a vital resource if a loved one suffers a severe medical event. Medicare can cover the initial short-term, intensive home care, giving you time to make arrangements for long-term care if necessary.
The following are the requirements that must be met to receive Medicare coverage for home health care.
- The patient’s doctor prescribed home health care
- The situation requires part-time skilled nursing care or physical, speech, or occupational therapy
- The home health care provider must be a Medicare-approved agency
- The patient must be confined to their home due to an injury, illness, or other medical condition (the ability to leave home to receive medical care could result in being ineligible for Medicare coverage)
- The doctor must collaborate with the home health care agency to set up a care plan
Medicare Part A will pay 100% of all home health care costs (assuming they are covered). There is no limit on the number of home visits a patient can receive; Medicare pays for all visits as long as the coverage is in place. Medicare will also pay for the home care agency’s initial evaluation. It’s also important to keep in mind what Medicare will not pay for. Medicare will not pay for the following services in the context of home health care: drugs and biologicals taken at home; meals delivered to patient’s home; housekeeping services; and, full-time nursing care.
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