Do You Understand Medicare's Home Health Benefit?

Medicare rules for coverage of home health care services are complicated and often misunderstood. Recent changes to Medicare criteria for coverage of rehabilitation therapy and skilled nursing care have expanded the availability of home health services.

 

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The Medicare home health benefit serves millions of Americans and plays a key role in our health care system. The benefit allows many homebound older adults to get the skilled care they need while remaining in their homes.

Medicare rules for coverage of home health care services are complicated and often misunderstood. Recent changes to Medicare criteria for coverage of rehabilitation therapy and skilled nursing care have expanded the availability of home health services to people with chronic debilitating conditions. At the same time, reductions in Medicare payments may be limiting access to such services, and proposals to impose a co-payment for services could further discourage their use.

What Services Does the Medicare Home Health Benefit Cover?

Medicare covers part-time or intermittent home health services, such as skilled nursing care, physical therapy, speech-language pathology, continuing occupational therapy, medical social services, and home health aide services. Medicare also covers medical supplies and durable medical equipment (e.g., wheelchairs and walkers) for use in the home if a physician certifies that they are medically necessary. Services that the Medicare home health benefit does not cover include most drugs, transportation, and housekeeping services.

A Medicare-certified agency must deliver Medicare home health services. Beneficiaries and their family caregivers can find information about the Medicare home health benefit, identify certified home health agencies in their area, and obtain information about the quality of care these agencies deliver on Medicare’s official website (www.Medicare.gov).

For more info please visit  Medicare Home Health Care Rules