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Home Health Care Medicare Coverage

Medicare coverage for home health care may help alleviate some of the financial strain after an injury, illness or other situation. Home health care is a range of services given to you in your home, often after an injury or illness.

Some examples of home health care services include:

  • Wound care

  • Patient and caregiver education

  • Injections

  • Intravenous or nutrition therapy

  • Monitoring serious illness

Qualifying for Medicare Coverage for Home Health Care

To obtain Medicare coverage for home care, a person must meet the following eligibility requirements:

  • The person must be homebound, meaning they have difficulty leaving the home or require assistance to do so

  • The person needs consistent skilled nursing services

  • There must be a face-to-face meeting with a doctor within 90 days before the first home care visit or within 30 days after the first visit has occurred

  • A doctor must certify that the individual is homebound and requires skilled care

  • The care must come from a Medicare-certified home health agency

If you meet these qualifications, you may be able to get help in your home for your medical needs.

What Types of Services Might You Receive?

Medicare home health services vary based on your situation. These skilled nursing services can be provided up to seven days a week, for a total of 28 hours maximum. You may be provided one or more of the following services:

  • Wound care

  • Care plan management

  • Medicare social services

  • Medicare supplies related to home health care

  • Regular care ( i.e., injections, catheter changes, observations, assessments)

  • Skilled therapy services (i.e., physical therapy, speech-language pathology occupational therapy)

Medicare can also provide coverage for home health aides who provide personal care services like bathing, dressing and toileting. But keep in mind that Medicare will not pay for a Medicare home health aide if it is the only required service needed and you do not need additional skilled care.

Understanding Your Policy and Coverage

Understanding the Medicare guidelines for home health orders is critical to ensuring you receive the level of care you need and manage your financial responsibilities properly. Original Medicare — including Medicare Part A and Medicare Part B — and Medicare Advantage (Medicare Part C) can provide this coverage. However, costs depend on the service and coverage plan unique to each person.

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