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One of the questions we are often asked by family members who need home healthcare or their loved ones is whether Medicare pays for in-home health care services. “In-home health care services”, also known as “home care,” refers to medical care or assisted care for anyone who needs additional support to live safely in their homes but for those who do not require full-time care at a skilled nursing facility. There are more than 11,000 home health agencies operating in the United States. If you’re on Medicare, it’s important to understand what benefits you’re eligible for under traditional Medicare.
Medicare Part A and Part B cover some home health services. These include:
- Part-time or intermittent skilled nursing care for those who need in-home assistance. This is generally defined as no more than eight hours a day and 28 hours per week.
- In home physical therapy for people who need additional support to maintain or restore their health
- Occupational therapy
- Injectable Osteoporosis drugs
For other services Medicare Part A and Part B cover, click here. A few items Medicare does not pay for include:
- 24-hour a day at home care
- Hiring an aide to help with home chores such as grocery shopping or cleaning
It’s important to remember that you are not eligible for the home health benefits if you need more than part-time or “intermittent” skilled nursing care under traditional Medicare also known as Original Medicare.
Before considering any home health care agency, confirm how much Medicare will pay and how much you’ll owe out of pocket by calling 1-800-MEDICARE. Every agency you are considering should be upfront about their coverage. Having a Medicare Advantage Plan can offer additional benefits not covered by Original Medicare. If you’d like to learn more about what these plans can cover, we can help advise on your best-fitting options.
Ari Parker is Chapter’s lead Medicare advisor. His number is 605-205-8869 and you can reach out to him at [email protected].