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Posted by Positive Aging SourceBook on 05/26/2022

Medicare and Home Care: Know the coverage options

Medicare and Home Care: Know the coverage options

When it comes to understanding Medicare coverage, many individuals can find themselves confused by a complex web of information. This especially applies to those who want to know if they are eligible for Medicare coverage when entering a nursing home or receiving home health care. Below is some helpful information on whether you can use your home health care benefits if you have Medicare and what services and products it will cover.

First, you can use your home health care benefits if all of the following applies to your situation. Your doctor must prescribe that you need medical care at home and create a care plan. The care you need has to be intermittent and in the form of skilled nursing care, physical therapy, occupational therapy or speech therapy. The home health agency must be Medicare-certified and you must be homebound, or unable to leave the home unassisted.

Once you have established those requirements, it is important to understand what Medicare will actually cover, which includes the following:

•    Home health aide services on a part-time or intermittent basis, as long as there is a skilled need

•    Medical social services

•    Certain medical supplies

•    Durable medical equipment (wheelchair, walker, bedside commode, etc.)

Given the services and products that Medicare does cover, it is also valuable to take note of what is not covered. Care that is required 24 hours a day will not be covered. Other services not covered include personal care provided by home health aides such as bathing and dressing, along with homemaker services like cleaning and laundry. Also not included are home-delivered meals.

If you require care that goes beyond intermittent visits for a limited amount of time, or if your needs are not covered by Medicare, an important option to consider is private duty home care. For more information on Medicare coverage, visit medicare.gov.

Information adapted from medicare.gov.

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