Medicare covers 100% of the cost of home health care services, but there are a few things to keep in mind. If your doctor prescribes durable medical equipment for use in your home, you'll have to pay the Part B deductible and the 20% coinsurance for Part B. Your provider can provide you with the exact amounts before giving you the DME. Medicare only pays for a personal home health assistant when a person also receives skilled nursing care or rehabilitation services through the home care service.
Medicare doesn't cover personal home health aides as a stand-alone service. Each Medicare Advantage plan will have unique rules and requirements for home health care, so be sure to review your plan materials carefully. Medicare also doesn't cover certain services, such as foot care, regardless of whether they include home health care. Covered services and enrollment requirements vary depending on each state's home and community services program. Home care is primarily about helping a person receive care in their own home rather than in the hospital when appropriate. Ask the home health agency to hold a meeting with the patient and family before any interruption or reduction in services to discuss whether the proposed measure is appropriate and whether care is still needed.
You're generally not eligible for Medicare home health benefits if you need full-time skilled nursing care for an extended period of time. Even with all of this information, differentiating between home care and home health care can be confusing. The agencies that offer these services are called home care agencies and should not be confused with home health agencies that offer home health care services. If home health care is going to be discontinued inappropriately, follow the steps outlined in the Center for Medicare Advocacy's self-help package for quick home health care appeals.
Medicare beneficiaries who meet certain criteria may be eligible for home health care under Parts A and B. For Medicare to cover your home health care, your healthcare provider must certify that you need these services and that they are medically necessary. In most cases, part-time or intermittent time means that you may be able to receive skilled nursing care and home health care services for up to 8 hours a day (combined), for up to 28 hours per week. Ask the home health agency what services Medicare will pay for and which aren't covered, since some agencies may recommend services that Medicare doesn't cover.
Medicare covers the cost of medical equipment for household use in different ways, depending on the type of supplies or equipment.
