Home Health Care Coverage
Medicare will cover your care at home as long as you meet the coverage criteria. (When am I eligible?) You must need less than 8 hours of skilled nursing care a day for brief periods of time. Then, Medicare will cover your:
- Skilled nursing care. A nurse can come to your home to treat your illness or injury. This is covered on a part-time basis. You can only get this care from a registered or licensed practical nurse. Medicare pays for a nurse to watch you and see if your condition changes. It also pays for a nurse to teach you and your caregivers how to take care of you.
- Home health aide services. Home health aides can help you bathe, use the toilet, take your drugs, and do other daily activities. But Medicare only covers these services when you also need andget skilled nursing care.
- Note: Medicare does not cover full-time nursing and home health aide care. You can never get more than 35 hours a week of nursing and home health aide care. Usually Medicare covers up to 28 hours a week of this kind of care.
- Physical, speech-language, and occupational therapy. You can get treatments to help you improve or maintain your ability to move, talk, swallow, and do daily activities for as long as your doctor says you need them. These are called physical therapy, and speech and language therapy services. If you get this kind of skilled therapy at home, you can also qualify for home health aide care.
- Medical social services. A social worker can visit you at home to counsel you and help you deal with the social and emotional side of Alzheimer’s. Your doctor must order these services.
- Medical supplies. Your doctor may include orders for certain medical equipment and supplies if you need this equipment to live at home. This includes a walker, wheelchair, or oxygen equipment.
What does Medicare’s home health care benefit NOT cover?
Medicare will not pay for:
- Around-the-clock care at home: You will generally get up to 28 hours a week of nursing and home health aide care or less. Your nurse may visit you daily for short periods of time, depending on how you are doing.
- Home-delivered meals: You may get these through other resources in your community. To find them, visit the Eldercare Locator, or call 1-800-677-1116.
- Homemaker services: Medicare does not pay for shopping or cleaning help when this is the only care you need.
- Personal care, or custodial care: Medicare will not pay for someone to help you bathe, dress, and do other daily activities when this is the only care you need at home.