Home health care can be an integral component of many patients’ recovery processes, aiding seniors in getting back up after hospital stays or providing support to those living with a chronic condition like diabetes. Medicare coverage of home healthcare services may be confusing.
Medicare covers home health care that is considered medically necessary, such as wound care, physical therapy and some types of home health aides. Medicare also covers injections, medication management, nutritional guidance and patient/caregiver education services that may not fall under its coverage; your state Medicaid program may be able to assist if this applies to you.
Home health care may be needed due to chronic conditions like diabetes or Alzheimer’s Disease, surgery or medical emergencies requiring rehabilitation at home and sudden illnesses or injuries requiring temporary assistance. When your doctor recommends home health care services it’s essential that you understand exactly what’s covered so that you can plan accordingly and ensure you receive all the assistance required.
To be eligible for Medicare home health care services, a qualifying event and enrollment in both Parts A and B must occur. Your doctor must certify that you are homebound – meaning you require assistance or special transport when leaving your house; although you can leave for non-medical purposes such as visiting friends, getting your hair cut, attending religious services etc.
Medicare does not cover round-the-clock home health care services, but does offer many different forms of assistance. Home health care typically entails skilled nursing and therapy — such as physical or occupational therapy. Medicare also covers medical social work — which provides counseling related to your illness or injury.
Home health care may include assistance from a home health aide for bathing and dressing needs as well as meal preparation and shopping, home healthcare equipment such as bedside commodes, electric blankets and stationary oxygen machines as well as portable oxygen tanks and masks from physicians.
Notably, home health aide services may vary depending on your specific needs. Some can assess pain and help manage medication while others monitor blood pressure, heart rate, temperature as well as assist with safe navigation of the home environment.
In Florida, Illinois, Massachusetts, Michigan or Texas, home health agencies can submit a pre-claim review request to Medicare in order to learn whether they’ll likely cover your care before making decisions about care providers and costs. This can save time and effort. For more information about what home health care coverage Medicare may include for you speak with your physician and contact your local Medicare office.