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Home Health Care Services and Medicare

October 9, 2023

Home health care is an important service for many older Americans. It can help you save money compared to needing to go to the doctor or hospital, and it allows you to grow older at home instead of in a facility.

Home health care is an important service for many older Americans. It can help you save money compared to needing to go to the doctor or hospital, and it allows you to grow older at home instead of in a facility.

Many people wonder, “Will Medicare pay for home health care?” This article will take a look at exactly what home health care is and help you understand which home health care services are covered by Medicare.

What Is Home Health Care?

Home health care covers a wide range of services that are administered to patients at home. This care is just as effective as services you receive at a hospital or skilled nursing facility, but it saves you significant money — and you don’t have to travel!

What does home health care do? Some examples include administering injections, monitoring serious illness, helping with wound care, and more.

The focus of home health care is usually to treat an illness or injury. The goal is to keep you as independent and self-sufficient as possible, for as long as possible.

Who Qualifies For Home Health Care Services?

Does Medicare pay for in-home care services? In certain circumstances, it does.

To be eligible for Medicare coverage for home health care, you have to have Medicare Part A and/or Part B, while also meeting all of the following requirements:

  • You must be under the care of a doctor and your services need to be part of a plan of care regularly reviewed by your doctor
  • Your doctor certifies that you need intermittent skilled nursing care, physical therapy, occupational therapy, or speech-language pathology
  • Your doctor must certify that you’re homebound

For physical or occupational therapy or speech-language pathology, your condition needs to be expected to improve in a predictable and reasonable timeframe, and you must require the therapist to do the therapy.

Does Medicare Part B Cover Home Health Care Services?

Normally, home health care services are covered by Medicare Part B. To receive coverage, you need to be homebound and in need of skilled care. You don’t need a previous hospital stay to qualify.

The good news is that if you need these services and qualify for coverage, you are covered 100%. There is no coinsurance or copayment for Part B-covered home health services.

Does Medicare Part C Cover Home Health Care Services?

Medicare Part C, known as Medicare Advantage, is a full replacement for Original Medicare. They are required to offer at least as much coverage as Medicare Part A and B, but often go beyond and have additional coverage.

For instance, if you need non-skilled in-home care, like medication assistance, grooming, mobility assistance, or other services, many Part C plans will offer some coverage.

You’ll need to research your Medicare Advantage plan to find out exactly what coverage is available and what your copayments and deductibles are. However, you will never get less coverage than you would with Original Medicare.

Does Medicare Supplement (Part F) Cover Home Health Care Services?

Medicare Supplement plans help cover costs in Original Medicare that are not covered by Medicare Part A and B. This might include assistance with coinsurance or copayment amounts or excess charges.

Because home health care services are 100% covered with Medicare Part B, with no coinsurance or copay, a Medicare Supplement plan does not affect how much you pay for home health care with Medicare.

Medicare for Home Health Care: Compare Medicare Plans

Choosing the right Medicare plan can be challenging. There are a lot of options and the best choice for you will depend on your specific health needs.

If you’d like to talk to a licensed insurance agent to compare Medicare options, we’re here to help. Contact us today!

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