Medicare Part B benefits help pay for home health services, including caregivers. However, it doesn't cover 24-hour care, meal delivery, or personal care. However, it doesn't cover 24-hour care, meal delivery, or personal attention when personal attention is all that's needed. While these services are covered, they are usually provided by professionals such as nurses, therapists, or assistants employed by the agency.
Medicare doesn't pay for custody care (e.g., it's important to note that Medicare doesn't pay family members to provide these services, even if the family member is the primary caregiver). Medicare Advantage (Part C) plans are offered by private insurance companies and can provide additional benefits that are not covered by Original Medicare. Some plans may offer limited coverage for services such as home care, adult day care, or respite care. However, these benefits vary widely between plans and usually don't include direct payment to family caregivers.
If a person with a disability is already receiving Medicaid, their state may allow a family member or friend to become a paid caregiver. Many states call this a consumer-oriented personal assistance program. Each state has different requirements and rules. And the amount the program pays you to care for a family member varies by state.
Contact your state's Medicaid office for more information. While Medicare stipulates that a person must remain homebound to receive coverage, they can leave home for short periods to attend doctor visits or for non-medical reasons, such as religious services. If you need help finding a certified agency near you, Medicare offers a tool called home health comparison on its website. The agency must also tell you (both verbally and in writing) if Medicare won't pay for the items or services it provides and how much you'll have to pay for them.
Medicare Part B covers treatment with medications prescribed by a doctor, but it doesn't cover medical supplies, such as bandages, that are used at home. Often, this model allows more people to take advantage of paid family leave, because those who work for smaller employers or who are self-employed can afford coverage. If your loved one is eligible to be considered your dependent and you pay for your care so that you can work or look for work, you may be eligible for the dependent care credit. Medicare Supplemental Insurance (Medigap) helps pay for out-of-pocket expenses that original Medicare doesn't cover, which could reduce your overall health care expenses. Based on this demonstration, your home health agency can submit to Medicare a request for a pre-claim review of coverage for home health services.
The Medicare home health care benefit is designed for part-time or intermittent care and is generally limited to a maximum of 8 hours per day and 28 hours per week (with possible extensions to 35 hours under certain circumstances). While Medicare provides some coverage for home health care services, it's important to understand exactly what it covers and doesn't cover before making care decisions. Without proper documentation, all the money you are paid for your care may have to be paid to Medicaid for your loved one to be considered eligible for future Medicaid benefits. While Medicare coverage for caregivers is limited to specific situations and doesn't include family caregivers, understanding the options available can help you find a solution that works for you and your family.
However, sometimes families who provide care can get financial help for specific purposes, such as foster care or the purchase of goods and services and, in some cases, to pay for the provision of care. If you receive your Medicare benefits through a Medicare Advantage (Part C) plan or another Medicare health plan, check with your plan for more information about your home health benefits. Before you start getting home health care, the home health agency must tell you how much Medicare will pay. The benefits of Medicare home health care services will not change, and the pre-application review process should not delay your access to home health care services.
