In-home care can be essential for some seniors, but it can also be an extra bill you might not want. If you have Medicare, you may be wondering if your Medicare will cover in-home care? Maybe you are recovering from surgery and need help doing things in your home, or you cannot do everything in your home like you used to and require that care for your daily functions. This may be frustrating for you, and your situation may require someone to come to your house to help you. Keep reading to find out if Medicare will cover these in-home care services for you.
What is Home Care and What Does it Consist of?
For starters, let’s talk about what in-home care is and the different types of in-home care. In-home care is for people with special needs or needs to receive professional support from someone who will come and stay in their home. In-home care is for people who are recovering from surgery, disabled, or chronically ill.
This type of care consists of a caregiver helping you with your care, i.e., bathing, getting dressed, household chores like laundry, cleaning the house, yard work, cooking for you, helping you remember to pay bills, and of course, in-home health care.
You can receive any in-home care you need in your home, depending on your situation. In-home care is beneficial for those who cannot do daily things for themselves, and it makes all the difference for them in the end.
What to Expect from In-Home Care?
To begin in-home care, you will need a doctor’s order. Once you get doctor’s orders for in-home care, a home care agency can then schedule an appointment with you to come to your home. Once you have your in-home appointment with them, you will discuss your needs, and they will ask you some health questions. The agency will tell your doctor about your care and keep them updated with how you are doing. They will also develop a plan of how often they will see you or perform in-home care in your house.
Does Medicare Cover In-Home Care?
Now, down to the good stuff. Does Medicare cover in-home care? Medicare does cover some parts of in-home care. Both Medicare Part A and Part B cover home health services such as:
- Part-Time Nursing Care
- Physical Therapy
- Speech-language pathology
- Personal hands-on care
- Occupational therapy
However, Medicare will not pay for 24-hour home care, meals delivered to you, household chores such as shopping and cleaning if that is all you need, and personal care such as bathing and going to the bathroom if that is all you need.
Who with Medicare is eligible for this?
Anyone with Medicare who meet the below conditions may qualify for in-home care:
- You must be under a doctor’s care, and your doctor must review the plan that the in-home agency creates for you.
- Your doctor must verify that you need one or more of the below:
- Nursing care
- Physical therapy, occupational therapy, or speech-language pathology. Your condition must be expected to improve, have a plan to improve your situation safely and effectively. Have a nurse/therapist do maintenance therapy for you effectively.
- Your doctor must verify that you are homebound.
If you receive Medicare-approved in-home care, you should expect to pay the Part B deductible. If you only have Original Medicare, you can expect to pay a 20% coinsurance for in-home care after you have paid the Part B deductible.
Yes, Medicare will likely cover Medicare-approved in-home care for you if you meet certain qualifications. As with most things in life, though, Medicare does draw a line in the sand of what they will and will not cover associated with in-home care. Your Medicare Part A and Part B will cover most of the in-home care costs as long as it is within regulations. If you are looking to receive in-home care and want to know if your program matches the principles, you can also talk to a Medicare specialist to determine if you are covered.