Does Medicare Cover Home Health Care Services?

Medicare Home Health

Qualifying for Home Health on Medicare can be Difficult

With people living longer lives today, it is becoming more common to require at least some amount of assistance at home. This care is oftentimes for basic needs, such as dressing and bathing.

But, while many people assume that Medicare will pick up the cost of home health care services, this is not necessarily the case. Because of this misconception, many are surprised to discover that most – or even all – of their home care costs must be paid for out-of-pocket.

What Type of Home Health Care Does Medicare Pay For?

Depending on the services that you require, home health care may be provided either through Part A or Part B of Medicare. However, in order to qualify for this coverage, it is necessary that you meet all of the following conditions

First, you are required to be under a doctor’s care – and you must also be receiving services under a plan of care that was created by a doctor, as well as regularly reviewed by a medical professional.

You must also either need, or a doctor must certify that you require, one of more of the following:

  • Intermittent skilled nursing care.
  • Physical, speech-language, and / or continued occupational therapy services (but Medicare coverage only takes place when such services are a specific, safe, and effective treatment for your condition. In addition, you must also require a skilled therapist to provide these services safely, or your condition must be expected to improve within a reasonable amount of time).
  • You must be homebound – and a doctor must certify that you are in fact home bound.

Provided that you qualify for home health care services through Medicare, you will typically not have to pay any out-of-pocket costs for your covered home health visits. If you need more than just part-time or intermittent skilled nursing care, then you will not likely qualify for home health benefits through Medicare.

If you or a loved one requires home health care and are covered by Original Medicare (Part A and Part B), you can find more information on Medicare’s coverage of these types of services by going to: https://www.medicare.gov/coverage/home-health-services.