Part A covers inpatient hospitalizations, care in skilled nursing facilities, palliative care, and some home health care. In general, Medicare Part A helps pay for the hospital care you receive in hospitals, critical access hospitals, and skilled nursing facilities. It also helps cover palliative care and some home health care. Home health care services must be requested by a doctor or other medical professional and must be provided by a Medicare-certified home health agency.
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. Ask the home health agency what services Medicare will pay for and which aren't covered, since some agencies may recommend services that Medicare doesn't cover. 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.
However, Medicare home care benefits can cover personal care that is provided in conjunction with eligible home care services, such as transitional home care. When your other home health care needs end, you can continue to receive occupational therapy covered by Medicare under the home health benefit, if you need it. No, Medicare won't pay for non-medical home care if this is the only type of service a person needs. 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.
Medicare covers home health care services that are considered reasonable and necessary for the treatment of an illness or injury. 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. 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.
However, you may be responsible for 20% of the amount approved by Medicare for durable medical equipment and the standard Part B deductible applies.
