Medicare provides coverage for a variety of home health care services, as long as the services are necessary to treat an injury or illness. Medicare may cover up to 8 hours of home health care a day, for a maximum of 28 hours per week (this may vary case by case).
Home health care services covered by Medicare
- Rehabilitation therapy
- Rehab services help individuals regain daily function and become more independent in everyday activities. Services include, but are not limited to, physical therapy, occupational therapy and speech therapy.
- Medical supplies and equipment
- Medicare will cover the cost of equipment/supplies on a case-by-case basis. For example, Medicare may cover the cost of renting certain equipment, such as a hospital bed or wheelchair, though the individual can purchase the equipment at a later date. Covered equipment/services include canes, infusion pumps, hospital beds, traction equipment, wound dressings and supplies, and more.
- Medical & social services
- These services, typically assistance from a social worker or counselor, are offered with the goal of helping individuals deal with emotional issues that interfere with recovery/rehabilitation.
- Skilled nursing care
- Services include wound care and dressing changes, tube feedings, IVs and education in disease management.
- Personal care
- Services include assistance with personal activities such as bathing, using the bathroom, dressing and any other activities affected by the disease/illness.
Qualifying for home health care coverage
To be eligible for Medicare home health care coverage, one must meet the following criteria:
- Must be homebound: unable to leave your home without considerable effort and/or without the use of a mobility aid, such as a cane or walker, and/or the assistance of a caregiver
- Must have coverage through Medicare Part A (hospital insurance) and/or Medicare Part B (medical insurance)
- Must be under the care of a registered nurse/doctor, or of a medical professional who works directly with your doctor
- Must be under a care plan created by your doctor/nurse, with the outlined services reviewed regularly by the doctor, AND require any of the following:
- Intermittent skilled nursing care
- Physical therapy
- Speech-language pathology
- Occupational therapy
- Services must be provided by a certified home health care agency, such as Royal Oaks Home Care.
NOTE: Medicare will continue to cover your home health care services as long as your doctor recertifies your care once every 60 days.
