Medicare covers limited amounts of in-home health care.
Medicare provides eligible individuals with health care coverage. Traditionally, Medicare Part A provides hospital insurance for all eligible applicants at no additional charge. Parts B through D are optional Medicare coverage plans designed to fill in the "gap" where traditional Medicare coverage ends. Medicare Part A only covers limited and intermittent amounts of in-home health care. Part B home health care coverage depends upon whether the plan selected by the paying recipient allows it.
Medicare Eligibility
Medicare is a government-funded health insurance plan to help people age 65 or older, people under 65 with eligible long-term disabilities, and individuals with a progressive form of kidney disease requiring transplants or dialysis.
Medicare Part A
Medicare Part A covers eligible individuals with required inpatient hospital care, inpatient nursing care for a limited time, home health care or hospice care. Medicare recipients do not pay monthly premiums for this coverage and automatically receive coverage through Part A. Part A recipients can receive limited home health care for physical therapy, nursing, pathology or occupational therapy. To receive the limited home health care benefits, patients must medically need the in-home care and be homebound or unable to leave home without major effort or additional assistance. Generally, an in-stay hospital visit triggers the limited home health care, typically only on an infrequent part-time basis for up to 30 days.
Medicare Part B
Medicare Part B helps cover home health care, outpatient services and physician's visits. Recipients pay a monthly premium for this optional coverage based upon their total adjusted gross incomes. Since recipients can purchase Part B apart from Part A, the home health care costs depend upon the individual's medical needs and ability to pay.
Covered Home Health Care
In addition to qualification requirements of necessary care for a homebound recipient, Medicare must preapprove or precertify providers for both Parts A and B. Medicare only covers intermittent care or home health care on a part-time basis under Part A. Part A coverage allows recipients care for fewer than eight hours daily within a three-week period. Since most individuals requiring federal health care assistance are eligible for only Part A, their home health care benefits last for a maximum of 21 days. Medicare does not pay for long-term health care. In some instances, Medicare may pay for a two-month period of care if certified as medically necessary.
Types of Covered Home Health Care
If Part A recipients are receiving the home health care within the allowable time frame, then Medicare covers nursing care, physical therapy, pathology services, social services and medical supplies. Medicare covers limited medical equipment expenses such as wheelchairs and hospital beds. Medicare will not cover 24-hour home health care, meal delivery services, housekeeping services unrelated to medical care, or bathing and personal hygiene care. Part B recipients may receive coverage for these services depending upon providers' specific enrollment rules.
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