Is Home Health Care Covered by Medicare?

Home health care encompasses everything from physical therapy to hospice care and can be expensive. Seniors may wonder whether Medicare covers home health costs; unfortunately, the answer depends on your unique circumstances.

If your need for home health care services is medically necessary, Medicare Parts A and B could cover them. You’ll need a physician or other health care professional (like a nurse practitioner) to certify that part-time or intermittent skilled nursing care, therapy or assistance at home would help improve your condition; usually this certification occurs during or following a face-to-face visit. Your doctor will also establish and regularly review a plan of care detailing which services you require when as well as which providers will deliver them.

Medicare also covers home medical equipment and supplies like dressings, catheters and ostomy bags; once you meet your Medicare Part B deductible for these items, Medigap or Advantage plans typically cover any remaining 20% coinsurance.

To qualify for home health services, certain criteria must be fulfilled. First and foremost is having certification from either your physician or other health care professionals (like nursing nurses ) that you require intermittent occupational, physical and speech-language therapies; typically these services will be arranged through a Medicare-certified home health agency. Second is being housebound – meaning leaving requires special equipment or assistance from someone else; additionally you should not leave for nonmedical purposes like religious services, grocery store trips or attending weddings or funerals.

On the Centers for Medicare and Medicaid Services website, you can search for home health care agencies near your location. In addition, Medicare’s hotline offers pre-claim review for home health services before signing up – this may speed up the process and give you peace of mind knowing Medicare will cover these costs once eligible.

Home health care can be particularly useful during a coronavirus pandemic, helping prevent further spread of disease while freeing up hospital beds for those who require hospital care more severely. Furthermore, it may help avoid moving into an assisted living facility which often costs more than home health care services.

But Medicare won’t cover non-skilled home care such as medication reminders, bathing and grooming services, meal preparation or housekeeping; you must find another source or contact your Medicare Advantage plan directly in this regard; some Medicare Advantage plans might cover these services while others won’t.