Home health care includes a wide range of health and social services delivered in your home to treat illness or injury. If you qualify for the home health benefit, Medicare covers the following:
• Skilled nursing services, such as injections, tube feedings, catheter changes, observation and assessment of your condition, and wound care
o Provided up to seven days per week for generally no more than eight hours per day and 28 hours per week. In some circumstances, Medicare can cover up to 35 hours per week.
• Skilled therapy services, such as physical therapy, speech language pathology, and occupational therapy
o Note: You cannot qualify for Medicare home health coverage if you only need occupational therapy. However, if you qualify for home health care on another basis, you can also get occupational therapy. When your other home health needs end, you can continue receiving Medicare-covered occupational therapy under the home health benefit if you need it.
• Home health aide, who provides personal care services like bathing, toileting, and dressing
o Note: Medicare pays in full for an aide if you required skilled care. Medicare will not pay for an aide if you only require personal care and do not need skilled care.
• Medical social services, such as counseling or help finding resources in your community
o Medical social services are ordered by your doctor to help with social and emotional concerns you have related to your illness.
• Medical supplies, such as wound dressings and catheters
• Durable medical equipment (DME), such as wheelchairs and walkers
There are certain requirements one must meet to be eligible for the home health benefit. For example, an individual must be considered homebound and have a plan of care approved by their doctor. Do note, however, that during the current coronavirus public health emergency, some of these requirements have been changed to allow for greater access to home health care. It is also important to know that your home health care is covered by Medicare even if your condition is chronic or if you are not showing signs of improvement.
Speak with your doctor to begin home health care. If you have Original Medicare, call 1-800-MEDICARE or visit www.medicare.gov/care-compare to find a list of Medicare-certified home health agencies (HHAs). If you have a Medicare Advantage Plan, you should contact the plan directly for a list of HHAs in your plan’s network.
-Marci
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