When it is appropriate, home health involves assisting a person is receiving care in their own home rather than in a hospital. A Medicare-certified home health agency must deliver the service for Medicare to pay for it. People who use a non-certified home health agency will have to pay for their services out of pocket. In this article, we’ll go through how Medicare covers home health services.
What services does Medicare cover for in-home care?
For as long as it is appropriate and deemed necessary to treat an accident or disease, Medicare will fund various home health services. Medicare pays for up to 8 hours of care per day, up to a total of 28 hours per week. In addition, the insurance program covers up to 35 hours of home health care each week for some clients. On a case-by-case basis, Medicare evaluates the requirement for 35 weekly hours of care. The following services are covered under Medicare:
Rehabilitation therapy
Rehabilitation services assist a person in regaining everyday function and increasing their capacity to live independently regularly. Physical, occupational, and speech therapy are examples of these services.
Social medical services
A social worker or counselor will assist you with these services. In addition, they can help patients in dealing with emotional concerns that are preventing them from fully recovering after an illness or injury.
Health care at home
Personal care, such as dressing and bathing, is provided by home health aides. However, when individuals receive skilled nursing care or rehabilitation services through home health, Medicare only pays for a personal care aide. Therefore, home health personal assistants are not covered by Medicare as a stand-alone service.
Medical equipment and supplies
Part B of Medicare covers several medical supplies that are required for home health care. For Medicare to fund the equipment, it must be prescribed by a doctor. Medicare may cover medical goods and equipment such as canes, pumps for infusions, walkers\swheelchairs, hospital beds, traction equipment, nebulizer equipment, treatments, and supplies for wounds. Depending on the type of supplies or equipment, Medicare covers the cost of medical equipment for home use in a few different ways.
Nursing care provided by professionals
Part A of Medicare also covers skilled nursing care provided by home health, if it is intermittent or part-time. Intermittent nursing entails providing care for less than 8 hours each day for 21 days or up to 35 days in rare cases. It can also refer to nursing care provided on fewer than seven days per week. Skilled nursing care that lasts longer than 8 hours a day or is not intermittent is not covered by Medicare. For Medicare to pay for home health services, a registered nurse or licensed practical nurse must provide skilled nursing.
If you require occupational therapy, you will not be eligible for Medicare home health coverage. However, occupational therapy is available if you qualify for home health care on other grounds. If you still require occupational therapy after your different home health needs have been met, you can continue to receive Medicare-covered occupational therapy under the home health benefit.
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