Does Medicare cover home care?

Rohan Mathew

Updated on:

Medicare is a necessary health care service that covers the medical treatment and procedure expenses for individuals. It includes hospital stays and doctors’ visits. Medicare also has provisions covering some in-home health care aide and support systems for a few days a week and a maximum of eight hours a day. However, you must also understand Medicare does not cover everything. Therefore, you must know the details regarding your Medicare in-home cover provisions. TruBlue of Centennial is one of the services you can consult for more in-home care details regarding Medicare cover.

A good Medicare consultation is essential to understand the facilities you can take advantage of through Medicare cover concerning in-home care. However, you must first understand what comprises In-home care. In-home care services are of three types as follows.

Companion care

Companion care is a simple aide that does not include medical assistance. Companion care is crucial for many elderly patients to routine work, including fetching daily requirements from the market every day. If you care about loved ones and do not want them to be lonely, companion care is a perfect solution. The companion care workers spend quality time with elders playing games and keeping them engaged. It comes under standard in-home care.

Personal care

Personal care workers are concerned with activities of daily living (ADLs). The personal care aides also assist the seniors primarily and help them with daily activities such as bathing, getting dressed, eating, and moving around. Not all senior citizens can move freely and require help getting around. Medical care is limited to first aid services, and thus, it comes under the standard in-home care.

Home healthcare 

Home healthcare is a departure from the standard in-home care and involves medicare care through certified professionals. Certified medical practitioners and nursing aides are crucial in providing accurate and satisfactory medical and rehabilitative care. Therefore, home healthcare monitors patients with injuries, surgeries, chronic health issues, and speech therapy.

Clear and concise Medicare consultation clears the doubts regarding the type of care covered under Medicare. The clarity regarding Medicare inclusions and exclusion helps you determine the future course of your patient care. 

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In-home health care services, possibly covered by Medicare.

First, and foremost Medicare care is not applicable for long-term in-home health care services. Medicare services serve only part-time in-home care, and that too for a limited time. You as a patient must qualify for it based on the following requirements. 

You must be under medical observation and part of a detailed plan that requires regular checks and reviews by the physician.

Even though Medicare covers some of the in-home care services, the services you employ must be Medicare-approved. You can consult Medicare customer services to know more about Medicare-approved services.

For personal care, you will require the approval of the physician along with a recommendation letter. The letter of physician approval will comprise information about the assistance you use for daily movement. For example, you require a cane, a wheelchair, or a person to carry out daily activities.

Regular care like personal and companion, aside from the skilled nursing services, requires physician approval. 

You should be part of continuous therapy, like physiotherapy or speech therapy. You require language assistance like Speech-language pathology to improve your speech and communication.

In-home health care services covered by Medicare

If you satisfy the essential requirements for Medicare, it covers home healthcare, personal care, and companion care in varying degrees as follows. 

  • Part-Time skilled nursing care and services
  • Part-Time home care assistance services
  • Social services
  • Physical therapy
  • Occupational therapy
  • Communication and language assistance through experts like Speech-language pathology

Apart from the in-home care services, Medicare may cover the following.

  • Long-term medical equipment, which is durable
  • In-home care medical requirements
  • Injections and drugs for ailments like osteoporosis that affects bones 

Payment for medical supplies and equipment is under Medicare. Your coinsurance is taken care of by Medicare. Coinsurance is an assured sum that you have to pay to procure medical supplies and equipment. Coinsurance is a fixed percentage of the expenses. Generally, it is in the range of 20 percent.

What is not covered? 

The information about possible and confirmed in-home care benefits of Medicare help understands services that are not part of Medicare. Personal and home care assistance, care, and aides services comprise home cleaning, laundry service, and purchasing for daily needs. The in-home services are specific and only the ones included in the Medicare plan. 

If you have not explicitly added these services to the Medicare plan, you are ineligible for the in-home services. The exclusions comprise personal care services like home-delivered food services and 24-hour assistance and care services.

Medicare comprises much in-home services exclusion. However, it is also important to note that the essential services are dependent on the recommendation of the doctor you are attending. It is also necessary to understand that the approval and advice of your doctor need not qualify you for the services. Physician word is not the final word for the services to be available for you automatically. It is dependent on the need and requirements. The decision is specific to the understanding of the circumstances.

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