What does medicare cover for in-home services?

Part A covers inpatient hospitalizations, care in skilled nursing facilities, palliative care, and some home health care. Medicare pays for Home Care near Chandler AZ for eligible, homebound older people who require essential medical services for the treatment of an illness or injury. A doctor or other medical professional must request home health care services and these must be provided by a Medicare-certified home health agency. Personal care services, such as help with activities of daily living (ADL), may also be covered if they are provided as part of a general plan that includes skilled nursing care. 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.

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. However, Medicare home care benefits can cover personal care that is provided in conjunction with eligible home care services, such as transitional home care. Under Medicare Part B, you are eligible for home health care if you are homebound and need specialized care, even if you haven't been hospitalized before. Medicare will only pay for the services of a home health assistant if you also need skilled nursing care or specialized therapy.

Under Medicare Part A (sometimes referred to as “hospital insurance”), you may be covered by home care services if you had to spend a minimum of 3 consecutive days in the hospital as an inpatient or if you had to stay in a skilled nursing facility (SNF) for the same length. Covered services and enrollment requirements vary depending on each state's home and community services program. No, Medicare usually covers 100% of all approved home health care costs, but you may have to pay 20% of the amount approved by Medicare for any durable medical equipment. Before you start getting home health care, the home health agency must tell you how much Medicare will pay. You're generally not eligible for Medicare home health benefits if you need full-time skilled nursing care for an extended period of time.

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 services.

Alan Furner
Alan Furner

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