If you require home health care services, it’s essential that you understand whether Medicaid or Medicare covers your expenses. Both programs offer coverage; however, each has unique eligibility rules and requirements. In this article we’ll outline both programs’ coverage requirements so that you can make an informed decision for yourself.

Home health care refers to an umbrella term for medical services provided at home, including nursing care, physical therapy and speech-language pathology services. All these services aim to support independent living for those who need it.

Home health care services provided to an individual depend on their doctor’s plan of care, usually 60 days but sometimes extended further if necessary. Home health aides also help with personal tasks like grooming, dressing, and cooking as part of this caregiving experience.

Home health care typically involves skilled nurses or therapists visiting an individual’s home and performing care, typically under Medicare Part B coverage. To be eligible for this benefit, individuals must be homebound (confined within their own dwelling ) and require intermittent skilled nursing or therapy services at home.

Medicaid’s Home and Community Based Services waiver programs also provide home health care to people at risk of institutionalization, offering adult day care, home health aides and transportation assistance as services that support living independently at home. In order to qualify for these programs, individuals must meet functional eligibility standards established by their state.

Some states stipulate a nursing home level of care is needed in order to qualify for these programs, while others employ more flexible standards – for instance Pennsylvania Home and Community Based Services Waiver allows individuals accessing personal care aides, residential care and day habilitation in their own homes.

Individual Options Model (IOMS) home health care program offers coverage to individuals in need of long-term home health services who do not want to live in nursing homes. With this plan of care tailored specifically to a person’s medical needs and goals.

Eligibility criteria for home health care vary by state, but typically include being enrolled in Medicare or Medicaid. Many seniors and disabled individuals opt for Medicaid as a way of receiving home health services without incurring costs out-of-pocket; to qualify under this program’s asset limit. Therefore, planning early is advised so you can benefit from it when necessary.