Coverage details · Physical therapy, occupational therapy, and speech-language pathology services (if you meet certain conditions) · Medical social services · Part See more. Medicare covers 100% of the cost of home health care services, but there are a few things to keep in mind. If your doctor orders Durable Medical Equipment to be used in home, you will be required to pay your Part B deductible as well as the 20% Part B coinsurance. Your provider will be able to provide exact amounts to you before delivering the DME.
Understanding Medicare’s limitations helps families plan appropriately for comprehensive home care needs. Each Medicare Advantage plan will have unique rules and requirements for home health care, so be sure to check your plan materials carefully. Medicare’s most significant limitation is its exclusion of custodial or personal care services when this is the only care needed. This type of plan is provided by private companies, must provide at least the same coverage as Original Medicare, and often includes additional benefits.
After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for Medicare-covered medical equipment. You may also have coverage for some supplies, such as catheters and wound dressings related to your condition when your home health agency provides them. Gain your inspiration here and find NCOA tools, tips, and resources to help improve your delivery and service. While home health services themselves are covered at 100%, durable medical equipment (DME) used at home follows standard Medicare Part B cost-sharing rules.
Medicare provides excellent coverage for skilled care needs, while families may need to arrange private pay, long-term care insurance, or Medicaid services for custodial care needs. Medicare’s home health services can anchor a broader care team that includes family members, friends, and privately paid home care providers. Part B covers medically necessary services, such as doctor visits, outpatient care, and some home health care services. Your Medicare Advantage plan may require you to get home health services from agencies they contract with.
