Does Medicare Cover In-Home Care Services?

2 May 2022

Many are convinced that in-home care services are beneficial to their loved ones or themselves. And yet some people are still hesitant to decide because they are concerned about their insurance. This article will discuss the answer to the question: does Medicare cover in-home care services?   

You and your reason to get for in-home care services

In terms of qualifications, Medicare supports people with disabilities, patients with renal disease, or 65 years old and above. When it comes to which type of service, it is easy to conclude those who stay and receive care in healthcare facilities can get approval. However, what is important to remember in Medicare eligibility is not the place but the reason to support your caregiving service.

Generally, Medicare covers in-home care services for as long as these are related to the health or medical condition of the patient. The insurance program also favors home health care services for short-term treatment. The medication should be temporary, like not more than three weeks. The time per day should be no more than eight hours. In this case, short term in-home care for the following may most likely be covered by Medicare:  

  • stroke 
  • injury 
  • lesions, 
  • burns, 
  • and other postoperative wound care.  

Hence, it is better to verify if there are exemptions or other considerations if the care recipient needs round-the-clock caregiving. It is the same with the complexity of the need for in-home care assistance. For example, aid for personal care and activities of daily living are typically not covered by the program. But it may reconsider when the recipient also proves the need for these services. 

Reminders about Medicare coverage of Home Health Care

Does Medicare Cover In-Home Care Services

Like in other areas, the national health program also determines whether to start and continue the support for eligible members. Here are a few factors to remember:  

Choose a Medicare-partner agency – It may be rare nowadays, but still, it’s good to verify if the in-home care agency you choose is in partnership with Medicare. If it is recognized, it is easier to know or process the approval for support. The agency may also guide the client on what to do and what to expect when it comes to Medicare coverage. 

Stay in touch with your doctor – Medicare recognizes the importance of regular involvement of a doctor in the in-home care services. In this manner, it is excellent if the eligible care recipient has a certificate of a doctor recommending in-home health care. The patient should also visit a doctor 90 days or less before starting the start of support. Otherwise, the patient must have a medical appointment at least 30 days after the approval. 

Aside from Medicare coverage, in-home health care services are cost-effective for their various benefits. First and foremost, these are affordable compared to caregiving in nursing homes or other facilities. Several doctors also recommend in-home health care, especially for seniors or patients who can no longer take long and frequent travel. Moreover, in-home care providers provide one-to-one service that is key to preventing problems such as the spread of infectious diseases or falls.