People With Medicare
Medicare Question of the Month
Each month, our expert showcases a Medicare question submitted by one of our readers. You may submit a question at any time and get a personal response.
This Month's Question:
My father has very bad heart disease and recently had to have his leg amputated. My mother has Parkinson’s disease and is unable to help him with his needs at home. What kind of in-home assistance could they receive through Medicare?
If you wish to see whether home health services may be appropriate for your parents, you might want to start by speaking with their primary care provider.
Your parents may be able to receive in-home help from Medicare if they meet all of the following conditions:
- At least one of your parent’s doctors must order the home health services. Care may be ordered for either or both of your parents.
- The orders must be provided to a Medicare-certified home health agency. You can find one on your own, or the doctor’s office may recommend a provider.
- The doctor will need to reorder the care as needed, and must see the patient periodically.
- For Medicare to cover your parents’ home health care they must be homebound. Generally this means that leaving home is difficult and doesn’t happen frequently.
- They must need physical therapy or speech and language services or intermittent (meaning not continuous) nursing care. The doctor’s order must specify what services are needed.
If your parents meet these conditions, Medicare may pay for their home health care. However, Medicare will only cover part-time or “intermittent” skilled nursing care, which is defined as care that’s needed for fewer than 7 days every week or fewer than 8 hours each day over a period of 21 days. There are a few exceptions to this rule.
Medicare does not pay for any of the following:
- 24-hour care at home;
- Meals delivered to your home;
- Homemaker services like shopping, cleaning, and laundry; and
- Personal care given by home health aides like bathing, dressing, and using the bathroom when this is the only care needed.
If you wish to find help with the above services, we strongly suggest you contact the Eldercare Locator at www.eldercare.gov or 1-800-677-1116 to find what assistance may be available in your area.
You can learn more about Medicare’s home health benefit here.
If you ever have questions about your Medicare coverage or benefits, you can get help in your local area. This service is free to people with Medicare and their families. A counselor can help you review your options, review Medicare rules with you, and help you get the services your family needs.
NEXT: More Questions