Medicare and Home Health Care
If you satisfy the requirements for home health services, Medicare will pay for:
• Medically necessary skilled home-care for a short time after discharge from the hospital. Skilled care refers services that require either a registered nurse or a licensed practical nurse.
• Home health services such as nursing care or other therapy on a part-time or intermittent basis.
• Medical social services, part-time or intermittent home health aide services, medical supplies for use at home, durable medical equipment, or injectable osteoporosis drugs.
To be eligible for Medicare support of home services:
1. You must be under the care of a doctor, and you must be getting services under a plan of care established and reviewed regularly by a doctor.
2. A doctor must certify that you need one or more of these:
a) Intermittent or part-time skilled nursing care (other than just drawing blood.) Full time skilled nursing care is not covered.
b) Physical therapy, speech-language pathology, or continued occupational therapy services (covered only when the services are a specific, safe, and effective treatment for your condition.)
The amount, frequency and time period of the services must be reasonable, and they need to be complex, requiring qualified skilled therapists who can do them safely and effectively. You may be eligible if the goal is either Restorative/Rehabilitative therapy or Maintenance therapy. Recently, Medicare has recognized that skilled care may be necessary even when care is not expected to prevent further deterioration or preserve current capabilities.
3. The home health agency caring for you must be Medicare-certified. (All About You! is Medicare-certified)
4. You must be homebound, and a doctor must certify that you are homebound.
During the period of Home Health Care, you may leave home for medical treatment or for short, infrequent absences for non-medical reasons, like attending religious services. You may still get home health care if you attend adult day care.
For more information, visit www.medicare.gov and search “Medicare and Home Health Care.”