How much does Medicare pay for in-home health care?

The advantages of home health care do not come without expense. Accordingly, it can be as expensive as the cost of assisted living depending on factors like salary trends in a state. Medicare, a health insurance program, is helpful to lessen the cost of home health care.    

Know if the care recipient is eligible

Medicare is one of the things seniors can count on for their home health care. American citizens and residents who reach 65 years old are typically eligible for this. Younger or non-seniors care recipients who are suffering from end-stage kidney disease or disability can benefit from this. However, people wonder if this program covers home health care like in-patient care.

The principal determinant of whether Medicare will pay for home health care is the plan of the care recipient. Generally, it has limited coverage for home care compared to in-patient. Typically, it excludes paying for daily living and personal care services such as housekeeping, errands, or bathing. However, this may be inapplicable if these are part of home health care. The latter engages nursing assistance for homebound patients. Housebound patients include those in need of occupational or physical therapy, injection of osteoporosis drugs, and speech-language pathology service. In general, care recipients considering this have to stay in the house for caregiving. 

Usually, it also favors medical-related support backed by a doctor. The insurance company will continue paying for any of these and other allowable services for as long as they and the patient’s doctor determine if a care recipient deserves home health care.

Another qualification it includes is if the home health care serves intermittently. It equally qualifies clients who only need part-time or short-term treatments like those recovering from injuries.  

Therefore, home care that is long-term and extensive is most like not eligible. The 24-hour caregiving, for instance, may not pass in the eligibility. 

Tips on costs and getting help for Medicare

Given the rules of eligibility and services that the program allows covering, it is vital to consult the company for your concerns. You can go straight to contacting your home health agency for the specifics of eligibility and cost. If you fall into a type of home health care they cover, they may shoulder everything or a percentage of the expense.

Examine your Medicare plan. Securing the eligibility and costs that the program can cover is imperative before arranging services. It is because there is an expense they can cover but cannot simply grant. Check if one’s policy includes medical devices such as a wheelchair. Usually, these are also not part of the original policies, Plan A and Plan B. You cannot also add these plainly if in case there’s a mistake. Although the Medigap plan or Medicare part C: advantage policy can reduce the expense for medical equipment by 20%.

Coordinate with the doctor or hospital. It is them who can testify if a care recipient can do the treatment or home health care. They also serve as a resource that Medicare and caregiving agencies consult for their businesses.