Medicare and Home Health Care

is home health care covered by Medicare

Sixty years ago, less than 10 percent of the American population was older than the age of 65. That share is projected to double by the year 2050. One of the natural by-products of the so-called “graying of America” is an explosion in the need for specialized medical services, but is home health care covered by Medicare?

With the costs of health care increasing each year, it is vitally important that patients and families understand just what is covered, and what is not.

What Medicare Covers

Medicare provide coverage for home health care for up to eight hours a day and no more than 28 hours per week. Certain medical supplies and counseling services area also covered, as well as occupational, physical and speech therapy. Medicare does not generally cover home custodial services, prescription drugs, meal delivery or 24-hour home care.

Conditions of Coverage

Medicare provides coverage only if four conditions are met:

  • A physician certifies that the patient is home bound and requires intermittent skilled nursing
  • A patient needs help from special equipment or other persons to leave the home or leaving home would be harmful to his health
  • Care is received from a Medicare-approved agency
  • A patient receives skilled care and/or skilled therapy

Is home health care covered by Medicare? In many cases, the answer is “yes,” but it is important to understand the guidelines and limitations.