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In-home Services Covered By Medicare
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The first step in getting Medicare coverage for home services is meeting the qualifications of a covered patient:
– The patient is homebound: Meaning that they are unable to leave home without considerable effort or without the aid of another person or a device such as a wheelchair or a walker.
– The requested care has been certified as medically necessary by an attending physician. Such certification is good for 60 days.
– The certification must follow an in-person exam of the patient, no more than 90 days before the home services start.
– Services provided must follow a detailed medical plan of care prescribed and reviewed by the certifying physician.
– All service providers must be approved by Medicare.
If a patient is qualified, the following services listed below can be covered by the patient’s Medicare.
The first step in getting Medicare coverage for home services is meeting the qualifications of a covered patient:
– The patient is homebound: Meaning that they are unable to leave home without considerable effort or without the aid of another person or a device such as a wheelchair or a walker.
– The requested care has been certified as medically necessary by an attending physician. Such certification is good for 60 days.
– The certification must follow an in-person exam of the patient, no more than 90 days before the home services start.
– Services provided must follow a detailed medical plan of care prescribed and reviewed by the certifying physician.
– All service providers must be approved by Medicare.
If a patient is qualified, the following services listed below can be covered by the patient’s Medicare.
Skilled Nursing Care
Only part time care by a nurse is covered, up to eight hours a day or 28 hours a week. Such care would be things like wound care, administering medicines and treatments by injection or IV, and monitoring the patient’s vitals (temperature, blood pressure, pulse, etc.). Note that a patient who needs long term or full time nursing care will not be eligible as a “home care” patient.
Home Health Aides
Covered care includes help with personal activities such as bathing, dressing or going to the bathroom, eating and simple cleaning only if such assistance is necessary because of your illness or injury. This coverage does not include full housekeeping services. Also, Medicare covers these services only if you are also getting covered skilled nursing or therapy services.
Occupational, Physical and Speech Therapy
Services by certified professional therapists to help restore or improve your ability to perform everyday physical tasks, or to properly speak or walk in the aftermath of an illness or injury or to help keep such impediments from getting worse.
Medical Supplies
Provides coverage for medical supplies used by the service providers in treating the patient, including bandages, medical needles, tubing and bags and related items. Certain medical equipment, such as wheelchairs and walkers, can also be covered if supplied by your home care service provider. However, these medical equipment items require a payment of 20% by the patient.
Medical Social Services
Services such as counseling for social or emotional concerns related to or stemming from the patient’s illness or injury, and help finding and securing governmental and community resources for additional assistance.
