Medicare & Home Health Care

Many elderly and disabled Americans rely on Medicare to pay their doctor and hospital bills. However, some elderly and disabled individuals have a difficult time getting to the doctor or hospital due to mobility issues. These beneficiaries can take advantage of the Medicare home health benefit.

Definition

Home health care offers beneficiaries with debilitating diseases and injuries access to therapies and personal care from their own homes through home health agencies.

Qualifications

A beneficiary can qualify for the Medicare home health benefit if he is considered homebound and the doctor orders skilled nursing therapy or care. The home health agency must be Medicare-certified.

Services

The home health benefit primarily covers skilled nursing care and therapy including physical, occupational and speech therapy. If needed, personal care will be provided. Social services and medical services are also available to the beneficiary.

Payment

Part B pays for the home health benefit, unless the beneficiary was recently treated in a hospital or skilled nursing facility. In which case, Part A pays for the first 100 days before Part B begins coverage.

Time Frame

To receive care, a beneficiary should get a doctor’s approval first. Second, the doctor will write out a plan of care with a home health agency medical director. The plan of care will need to be revisited every 60 days. Medicare will pay for the benefit as long as the doctor continues to write a plan of care every 60 days.