Is Home Health Care Covered by Medicare?

Home health care can be an ideal way to recover from an illness or injury in their own environment. The goal is to help people become independent again at home – home health care may include physical therapy, occupational therapy and speech-language pathology services as well as medical social services, home health aides or supplies delivered right to your house.

Medicare may cover some costs associated with home health care depending on what kind of assistance is necessary and your specific medical conditions. Medicare typically does not cover custodial services like meal preparation or bathing; however, if you need a limited amount of help performing daily tasks then their home health program might be the right solution for you.

To qualify for home health care, you must be under the care of a doctor and have an established plan of care that has been reviewed. Your plan of care should outline which types of home health care you require on an ongoing basis as well as any necessary medical equipment or supplies. Your physician must also certify that you are homebound – meaning leaving home requires significant effort or help from devices like wheelchairs or walkers; although brief trips out are allowed such as doctor’s appointments, nonmedical events, religious services and similar.

Medicare Part A and B are required in order to access home health services under Medicare home health benefits, while your home health agency must be Medicare-approved and contracted with them in order to deliver these services. Whenever Medicare home health coverage ends and when renewing services are requested by an agency, your doctor must submit new certification each time before receiving services again from them. In the event that it decides it won’t approve these services, then an Advance Beneficiary Notice (ABN) should be sent.

Home health care can be extremely helpful to patients, yet there are certain restrictions associated with it that must be understood in order to prepare yourself in case there’s no longer sufficient support available within your own home.

Your physician and nurse from the home health agency should discuss your home healthcare needs regularly to ensure you receive all of the care that will support a speedy and complete recovery. They should also outline any costs not covered by Medicare in an Advance Beneficiary Notice (ABN), before providing supplies or services not covered. If any services or supplies fall outside this coverage, an appeal can be filed with the home health agency.

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