Most seniors would prefer to live at home rather than in a nursing facility. A goal of many Medicare and Medicaid programs is to help seniors remain in their own homes.
We are frequently asked about Medicare’s home health benefit. It is widely thought that Medicare’s home health benefit is short-term and limited to elders who are recuperating from illness or injury; but this is not the case. In fact, Medicare’s home health benefit is available to all seniors who meet program eligibility criteria and has no durational limit, which means the benefit does not end after a certain amount of time. Under Medicare, seniors do not have to pay an additional deductible or any other fee for the Medicare home health benefit in order to receive skilled nursing and home health aide care, in their own home, as authorized by a physician.
Here are the requirements to to qualify for Medicare’s home health benefit:
- A senior must be considered “homebound,” meaning that leaving the home is difficult and done infrequently. A senior may attend medical appointments or leave the home occasionally for other special reasons and still be considered homebound.
- To qualify for the home health benefit, a senior must need some skilled nursing care periodically or skilled speech or physical therapy.
- Under the Medicare home health benefit, home health care must be provided by a Medicare-certified home health agency
- It must include a care plan developed and reviewed by a physician. According to Medicare rules, a senior must visit a medical doctor within three months of the start of services, or within 30 days after services commence (video conferencing is OK). Personal care, some associated light housekeeping (including meal preparation, laundry, etc.) and medical equipment (such as walkers, tub seats, and medical supplies) constitute home health care.
It’s also good to note that hHome health care provided by a Medicare-certified home health agency cannot be discontinued without (at least) two days verbal notice, and a senior can appeal the decision.
Medicare Home Health Details
Here are the details, as provided by Medicare.gov:
Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services like these:
- Part-time or intermittent skilled nursing care
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Part-time or intermittent home health aide services (personal hands-on care)
Usually, a home health care agency coordinates the services your doctor orders for you.
Medicare doesn’t pay for:
- 24-hour-a-day care at home
- Meals delivered to your home
- Homemaker services
- Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need
Furthermore, if you are in Florida, Illinois, Massachusetts, Michigan, or Texas, you may be affected by a Medicare demonstration program. Read more, and scroll down for the information.
Read more about Medicare Home Health Basics
Home care counselors at Safe at Home Healthcare are available to talk with you about your in-home care needs including how to reduce caregiver stress while providing better, affordable care, including live-in care. We are an elder care agency providing home care in the Chicago metro area.
