Home health care helps individuals recover from illness or injury quickly in the comfort of their own homes, making Medicare coverage of this care more likely. Medicare typically covers most costs related to this care; however, details may differ depending on which plan one chooses. This article answers the question “How long will Medicare cover my home health care?”
Original Medicare (Parts A and B) covers skilled home healthcare services for an initial set period based on your unique medical needs, such as physical therapy, occupational therapy and speech-language pathology. Medicare Advantage plans (which combine Parts A and B into a private insurance option) may provide additional home healthcare benefits; these differ in how they approach this benefit.
Home healthcare services typically cover you for 60 days at a time, after which point your doctor must decide whether to recertify you for home health care coverage; if so, this coverage will continue indefinitely for another 60-day period if they deem that there is continuing need. Before doing this, however, they will need proof that this need exists.
Medicare covers medical supplies like wound dressings and durable equipment such as walkers, wheelchairs, oxygen equipment, hospital beds if they are recommended by your home health agency. Usually you pay 20% of the Medicare-approved amount for these items.
Medicare covers social services ordered by your physician to address social concerns related to your home healthcare, such as counseling or assistance in finding community resources. Medicare will cover up to two visits each week if you’re receiving skilled nursing or home health aide services.
Medicare does not typically cover custodial care services such as helping with bathing or dressing or meal preparation; however, some states provide such support through Medicaid programs.
Medicare-certified home health agencies must clearly and comprehensively outline what their charges are and the proportion that Medicare will cover, both verbally and in writing. Furthermore, an agency must give written notification before providing items or services that fall outside Medicare’s coverage.
Attaining out-of-pocket expenses with Medicare Advantage plans that offer home health care can help lower out-of-pocket expenses, according to research conducted by the Center for Medicare Advocacy (17 percent in standard plans and 31 percent of enrollees enrolled in special needs plans have some form of home healthcare coverage. You could also save out-of-pocket expenses by purchasing a Medigap policy which fills any coverage gaps left by Original Medicare; prices vary so it is wise to do your research prior to making any final decisions.