Home health services are covered by Medicare to provide a convenient and safe way for elderly people to get treated without having to leave the comfort of their homes. Now, before we discuss exactly what Medicare covers when it comes to in-home care, let’s discuss what home health care is.
What Is In-Home Care?
In-home care (also known as “home health care”) is a service covered by Medicare that allows skilled workers and therapists to enter your home and provide the services necessary to help you get better.
In-home care is especially helpful for immobile people and patients who have a difficult time leaving the house several times a week to go therapy or a hospital for treatment.
Home health care can include but is not limited to:
- Skilled nursing care: This refers to care that can only done by nurses with proper licensing. This care includes dressing wounds, rehabilitation deemed necessary by a doctor, and changing feeding tubes and other tube structures (catheters, IVs, etc.).
- Physical therapy: This is therapy that can be done at the home to help rehabilitate or treat conditions such as arthritis, broken bones, or other physical injuries.
- Occupational therapy: The AOTA says this therapy “helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities.” These activities include holding writing utensils, coping with now having to use a wheelchair, and other simple activities of daily living like grooming and feeding yourself.
- Speech therapy: Speech-language pathologists helps diagnose, assess, and re-develop speech in people who need it. For instance, a speech-language pathologist could be used after someone suffers a stroke and needs to learn how to speak again.
- Nutrition care: These workers help ensure you’re eating properly and living in the proper conditions. This isn’t a medical service, but it can be covered by Medicare if it’s in your area and your doctor deems that you need it.
- Safety services: This service features workers who specialize in transportation. They make sure that you’re living in a safe environment and can get from point A to point B safely if you can leave your house with assistance and it won’t worsen your condition.
In-home care plans are developed by a doctor and administered by skilled workers included registered nurses, speech language pathologists, occupational therapists, and social workers. Plans developed by doctors, which can include any of the aforementioned in-home care services, are evaluated every 60 days, or sooner if an intense program requires that level of attention.
Close attention must be paid to these in-home plans because Medicare coverage relies on it. According to the Medicare website, “your condition must be expected to improve in a reasonable and generally predictable period of time.”
What Parts Of In-Home Care Are Covered?
In-home care can cover a wide range of services, but they’re not all covered by Medicare. According to the Medicare site, the in-home care services covered by parts A and B include:
Medicare covers the other 80 percent of the costs under your Part B plan.
- Part-time or occasional (intermittent) skilled nursing care
- Part-time or occasional health aide care (This is different from nursing care because an aide’s
role is to help you get dressed, bathed, buy groceries, and other vital wellness necessities that help you live)
- Physical therapy
- Occupational therapy
- Speech-language therapy
- Medical social services, such as workers who help make sure you’re being billed for the right things and not being abused or taken advantage of by other people on your case
- Durable medical equipment needed to treat your condition
All of these services are covered under parts A and B of Medicare. The prescriptions you receive as part of your treatment are covered by Medicare, too, whether it’s under parts A and B or under your Part D prescription plan.
The services themselves will cost you zero dollars out of pocket (aside from whatever deductibles and copayments you pay for your Medicare plan). The only extra cost you’ll have for home health services is 20 percent of whatever durable medical equipment is needed for your services. Medicare covers the other 80 percent of the costs under your Part B plan.