Original Medicare (Medicare Part A and Part B) does cover some limited home health services.
Some Medicare Advantage (Part C) plans also cover home health care, as well as additional benefits such as caregiver support services and home modifications like wheelchair ramps and grab bars.
Some of the eligible home health services that Medicare Part A or Part B may cover include:
Home health services are typically covered only if they are considered medically necessary by your doctor. A home health care agency can help you coordinate your home health services.
Original Medicare does not typically cover:
Generally, anyone enrolled in Medicare Part A and/or Part B who meets the following conditions can have their home health care covered by Medicare:
Home health services are only covered by Medicare when they are specific, safe and an effective treatment for your health condition.
Even if your home health care services are covered by Medicare, you may have to pay some money out of pocket.
Typically, you’ll pay $0 for Medicare-covered home health care services and 20% of the Medicare approved amount for durable medical equipment (DME).
Ask your home health agency how much Medicare will pay before you begin receiving home health care. This can help prevent you from being surprised by unexpected out-of-pocket costs.
Although the housing cost charged by an assisted living facility will not be covered by Medicare, residents of assisted living homes can still benefit from Medicare coverage for certain services.
Assisted living facilities typically have nurses on staff or nurses who visit throughout the day to treat injuries, illness and help manage medications. Any such medical (non-custodial) care received in an assisted living facility by a health care provider may be covered by Medicare in the same fashion that it would be covered at other facilities.
Medicare Advantage plans combine the benefits covered by Medicare Part A and Part B into one single plan sold by a private insurance company.
Medicare Advantage plans cover the same home health care services that are covered by Medicare Part A and Part B.
Some Medicare Advantage plans may offer an expanded list of benefits that include:
Call today to speak with a licensed insurance agent who can help you compare Medicare Advantage plans that are available where you live. You may be able to find a plan that covers home health care, caregiver support and more.
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