Is Home Health Care Covered by Medicare?

Home health care refers to any number of healthcare services provided at home by healthcare professionals. You may qualify for home health services if you have Medicare Part A or Part B coverage and your doctor certifies you need home healthcare because of an illness or injury, although even without these coverage options you could still qualify if you purchase a Medigap policy that includes these benefits.

To qualify for home health care coverage, your physician must certify that you are homebound and require short-term skilled nursing care or other help in your home due to illness or injury. He/she should also devise a plan of care showing how home health care will aid your recovery; and have Medicare-approved agency provide services.

Your loved one or you may require home health care if they have a serious illness such as cancer, heart disease or lung disease; recently left hospital after having surgery; experienced surgery itself or needed hospital care such as stroke or infection; or have chronic conditions like diabetes or Alzheimer’s.

Once your doctor determines you need home health care, either Medicare-approved home health agencies or an independent nurse will visit to assess the situation in your home and evaluate both physical and cognitive status as well as mobility within it. They will conduct assessments such as evaluation of physical impairment or lack thereof; mobility within home; how well you are able to move around safely etc.

Home health agencies approved by Medicare can provide skilled services, including therapy and other forms of assistance that will aid your recovery from illness or injury. Services might include physical therapy, occupational therapy, speech-language pathology services as well as home health aide support; in some instances you may even receive medical supplies, durable equipment (like walkers or crutches), social work services as well.

Medicare-approved home health care agencies can help you locate resources to cover nonmedical aspects of home health care, like chore assistance or bill payment assistance. Many patients also rely on family, friends, community resources or external funding programs as additional sources of non-medical home health care support.

If you live in Florida, Illinois, Massachusetts, Michigan or Texas, and would like to participate in a Medicare demonstration program which enables home health agencies to submit pre-claim reviews for Medicare coverage of home healthcare sooner, saving both time and money by expediting approval processes for Medicare-covered home health services. For more information or assistance contact your home health agency.

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