Home health services
Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services as long as you need part-time or intermittent skilled services and as long as you’re “homebound,” which means:
- You have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or help from another person) because of an illness or injury.
- Leaving your home isn’t recommended because of your condition.
- You’re normally unable to leave your home because it’s a major effort.
Covered home health services include:
- Medically necessary part-time or intermittent skilled nursing care
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Part-time or intermittent home health aide care (only if you’re also getting skilled nursing care at the same time)
- Injectable osteoporosis drugs for women
- Durable medical equipment
- Medical supplies for use at home
A doctor or other health care provider (like a nurse practitioner) must have a face-to-face visit with you before certifying that you need home health services. A doctor or other health care provider must order your care, and a Medicare-certified home health agency must provide it.
In most cases, "part-time or intermittent" means you may be able to get skilled nursing care and home health aide services up to 8 hours a day, with a maximum of 28 hours per week. You may be able to get more frequent care for a short time if your doctor or other health care provider determines it's necessary.
Medicare doesn't pay for:
- 24-hour-a-day care at your home
- Meals delivered to your home
- Homemaker services (like shopping and cleaning) that aren’t related to your care plan
- Custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need
You're not eligible for the home health benefit if you need more than part-time or "intermittent" skilled nursing care . You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care.
Your costs in Original Medicare
- $0 for covered home health care services.
- After you meet the Part B deductible, 20% of the for Medicare-covered medical equipment.
Before you start getting your home health care, the home health agency should tell you how much Medicare will pay. The agency should also tell you if any items or services they give you aren't covered by Medicare, and how much you'll have to pay for them. This should be explained by both talking with you and in writing. The home health agency should give you a notice called the Advance Beneficiary Notice" (ABN) before giving you services and supplies that Medicare doesn't cover.