Medicare Home Health Care covers short-term medical care at home for short periods. It covers skilled nursing care, physical and occupational therapy services, speech-language pathology services and speech pathologist consultation services; however it doesn’t pay for custodial services (help with daily tasks such as bathing and dressing or doing chores), long-term caregivers or custodial services (ie help with daily activities like bathing/dressing or doing chores).
To qualify for home health care, your physician must request it and your home healthcare agency must be Medicare-certified. Your physician must document a face-to-face visit within certain timeframes and certify that home health care will help with recovering from an illness or injury.
Your requirements may also include being able to leave only for medical treatments or short absences such as getting your haircut or attending church services. Your home health agency must also provide an itemized bill or plan of care prior to beginning care that details what Medicare covers and doesn’t cover.
As part of home health care, your physician must update your care plan every 60 days and notify Medicare of his or her judgment if you won’t progress enough for home healthcare to continue being paid by Medicare. Medicare must issue this “Advance Beneficiary Notice,” also known as an Advance Beneficiary Notice or ABN, at least 45 days before ceasing payments to cover home health services; it should include details as to why your doctor believes home healthcare remains necessary and how you can file an appeal against it.
Medicare covers both home health care and medical social services to assist you with emotional and mental aspects of illness, such as counseling or finding community resources. Medicare also covers medical supplies such as dressings or catheters as well as durable medical equipment such as wheelchairs or walkers – although you typically must pay 20% coinsurance plus your standard Part B deductible amount for durable equipment like this. If enrolled in a Medicare Advantage Plan, make sure your plan offers specific benefits!
Home health care costs can add up quickly, and Medicare Supplement Insurance (Medigap) or long-term Care Insurance (LTCI) could help ease expenses. While these private plans offer significant cost-cutting potential, not all insurers offer them.
Consider switching to a Medicare Advantage Plan that offers comprehensive all-in-one coverage rather than Original Medicare Parts A and B. Many Medicare Advantage Plans provide home health care as a benefit, with extras such as vision or dental coverage also provided by some plans. Doing this allows you to avoid additional coverage plans altogether while focusing on recovery without paying separate insurance plans for home health coverage separately. If already enrolled in an Advantage plan, inquire as to its coverage of home health care; if not available you could switch or sign up for one that does offer this feature or enroll in another plan or sign up for Long Term Care Insurance that does.