Original Medicare (Medicare Part A and Part B) does cover some limited home health services.
Medicare Advantage (Part C) plans also cover the home health care benefits offered by Original Medicare, and they may also cover additional benefits not covered by Part A and Part B.
What home health care does Medicare cover?
Some of the eligible home health services that Medicare Part A or Part B may cover include:
Home health services are typically covered only if they are considered medically necessary by your doctor. A home health care agency can help you coordinate your home health services.
What home health care does Medicare NOT cover?
Original Medicare does not typically cover:
- 24-hour-a-day care at home
- Homemaker services
- Meal delivery
- Custodial or personal care such as help with dressing or bathing, if that is the only care you need
Who is eligible for Medicare home health care?
Generally, anyone enrolled in Medicare Part A and/or Part B who meets the following conditions can have their home health care covered by Medicare:
- A doctor certifies that you are homebound
- You are under the care of a doctor
- A doctor certifies that you require one or more of the following:
- Part-time skilled nursing care
- Physical therapy, speech-language pathology, or occupational therapy services
Home health services are only covered by Medicare when they are specific, safe and an effective treatment for your health condition.
How much does home health care cost with Medicare?
Even if your home health care services are covered by Medicare, you may have to pay some money out of pocket.
Typically, you’ll pay $0 for Medicare-covered home health care services and 20% of the Medicare approved amount for durable medical equipment (DME).
Ask your home health agency how much Medicare will pay before you begin receiving home health care. This can help prevent you from being surprised by unexpected out-of-pocket costs.
Medicare may cover some services provided in an assisted living facility
Although the housing cost charged by an assisted living facility will not be covered by Medicare, residents of assisted living homes can still benefit from Medicare coverage for certain services.
Assisted living facilities typically have nurses on staff or nurses who visit throughout the day to treat injuries, illness and help manage medications. Any such medical (non-custodial) care received in an assisted living facility by a health care provider may be covered by Medicare in the same fashion that it would be covered at other facilities.
Doe Medicare Advantage plans cover home health care?
Medicare Advantage plans combine the benefits covered by Medicare Part A and Part B into one single plan sold by a private insurance company.
Medicare Advantage plans cover the same home health care services that are covered by Medicare Part A and Part B. Medicare Advantage plans may also offer additional benefits not covered by Original Medicare.
Call today to speak with a licensed insurance agent who can help you compare Medicare Advantage plans that are available where you live. You may be able to find a plan that covers home health care benefits covered by Original Medicare as well as additional benefits not covered by Part A and Part B.
Compare plans today.
Speak with a licensed insurance agent