There are several steps and conditions to qualify for home health care: If you meet these requirements, Medicare parts A and B may pay for some home health services, including: According to Medicare.gov, Medicare does pay for “part-time or intermittent home health aide services.” This is understandably confusing. After 60 days, Medicare will review your plan of care with your doctor to determine if care should be continued or not. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. If your doctor says you need skilled care, you may be able to receive personal care services while getting skilled care. Although Medicare covers long-term hospital care, you could face significant charges if you receive long-term care beyond three months. Private health insurers, like Humana, offer Medicare Advantage plans that can provide Part A and Part B benefits, in addition to a variety of additional benefits. These costs can include assisted living, nursing homes, or in-home care (including caregivers). The homecare being referred here is only for skilled homecare and will not pay for companions, unskilled care or 24-hour care. It can help you and your family choose the agency that is best for you. Which Medicare plans may be best for you if you know you need home health services? You want palliative care for comfort rather than treating Time to Learn What Medicare Part B Covers. Medicare doesn’t provide coverage for such care. Medicare coverage can cover home health care expenses but only intermittently or for short-term care. According to the U.S. Bureau of Labor Statistics, the typical educational level for a home health aide is a high school diploma or equivalent. Medicare pays for long-term care for a short time under specific requirements. If you have original Medicare (parts A and B, not Medicare Advantage), you may be able to purchase a Medicare supplement plan, also called Medigap. Total Medicare payments for long-term care delivered in an SNF are limited. Part B pays for some aspects of home health services, including medical equipment. Medicare will pay for in-home care up to seven days a week. You may receive treatment for social and emotional concerns if your doctors believe addressing those will help you recover quicker or may interfere with your treatment. Your Health Insurance Options in Retirement, Key Differences Between Medicare and Medicaid and How They Work, How Health Care Inequality Increases Costs for Everyone, The 8 Best Cancer Insurance Providers of 2020, Reasons Why We Need Health Care Reform in the US. The therapy must improve functions affected by your illness or injury or a skilled therapist must provide services that prevent your condition from getting worse. How long does Medicare pay for long-term care? Medicare doesn’t usually cover nursing home and long-term care. Some Medicare Advantage plans provide further coverage for home health services, and this information should be included in your explanation of benefits. Medicare doesn't generally cover long term stays in a nursing home. F 9. You must be under the care of a doctor who has created a plan for you that involves home health care. How Much Will I Have to Pay if I Qualify? If you require home health care for more than eight hours a day or for seven days per week, you’ll have to pay out of pocket. Although most home health care agencies are honest, there are plenty of instances of Medicare fraud. These include: If personal care services from a home health aide are the only care you need, Medicare doesn’t usually cover these. Medicare Part A is the portion that provides hospital coverage. Therapies like physical, occupational, and speech-language pathology are covered if they’re considered “reasonable and necessary.” Treatments must be specific, safe, and effective for your condition and too complex to administer on your own or by somebody without specific skills. If you have these plan types, you’ll likely need to get your home health services from an agency your plan specifically contracts with. Medicare will not pay for meals delivered to your home, services like shopping, laundry, and cleaning, and custodial or personal care—bathing, dressing, or using the bathroom. Medicare pays for inpatient hospital stays of a certain length. Medicare does cover home health care as long as it is deemed medically necessary by a doctor. As you review your bill look for services and equipment you never received, fake signatures, services ordered by a doctor that you’ve never met, and home health care agencies that offer you freebies in exchange for your Medicare number. 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