Medicare Home Health Coverage
Medicare Home Health Coverage helps older adults with illness or injury live independently for as long as possible. It is usually less expensive, more convenient and just as effective as a skilled nursing facility (SNF). Home Health services include intermittent skilled nursing care, physical therapy, occupational therapy, or speech pathology. It may also involve helping with activities of daily living (ADLs) such as bathing, dressing, and eating. In general, the goal of home health care is to treat an illness or injury and can often delay the need for long-term nursing home care.
It is important to understand that Home Health care is “medical” in nature. It does NOT include house cleaning, chores or cooking meals.
Who Is Eligible?
All people with Part A and/or Part B who meet all of these conditions are covered:
- You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.
- You must need, and a doctor must certify that you need, one or more of these:
- Intermittent skilled nursing care (other than drawing blood)
- Physical therapy, speech-language pathology, or continued occupational therapy services. These services are covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition. The home health agency caring for you is approved by Medicare.
- You must be homebound, and a doctor must certify that you’re homebound.
- You’re not eligible for the home health benefit if you need more than part-time or “intermittent” skilled nursing care.
- You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult daycare.
Got Medicare Questions? We Can Help.
If you are a senior and have Medicare questions regarding Home Health Care call Empower today. Let us help with your Medicare questions so you can get back to the activities you enjoy the most. 1-888-446-9157 or click here to get an INSTANT QUOTE