What happens when you arrive home from the hospital and realize that some additional help is needed? If you have Medicare, in-home care may be covered under certain conditions.

In-home care could be necessary if you’re ill or recovering from illness, or it may also be needed post-surgery. You may need in-home care requiring skilled nursing, physical therapy, or another type of medical service. Depending on your specific needs and condition, in-home care can keep you living contentedly at home instead of a nursing home. Unfortunately, Medicare doesn’t cover every type of in-home care, or every instance as it is needed.

In-home care:  medical vs. non-medical

If you’re looking for in-home care, it’s important to understand the difference between medical and non-medical when requesting assistance.  When it comes to Medicare coverage, care must be ordered by your doctor.

Medical care: If you qualify for the home health benefit, Medicare usually covers intermittent skilled nursing care, rehabilitative therapy, medication administration, medical-social services, and medical equipment in the home.

Non-medical care: Medicare typically doesn’t cover personal home services. Personal care, such as bathing, dressing and exercise, meal planning and prep, meal delivery, housekeeping, shopping, transportation services, companion service, and telephone safety checks are usually not covered.

Back to the Question: Does Medicare cover in-home care?

Medicare Part A and/or Part B may help pay for some, or all, of your in-home care, if:

  1. You’re under a doctor’s care who accepts Medicare assignment.
  2. You need special help or medical equipment, such as a wheelchair, in order to leave home and your doctor certifies you’re homebound.
  3. The doctor orders in-home care. The physician must certify that you are in need of in-home care and that you need intermittent, but not continuous, skilled care. Intermittent usually means up to 60-days of care at a time, rather than long term care.
  4. Your doctor has met with you in person to confirm that you need in-home care.
  5. You are able to obtain care from a Medicare-certified home health agency.

In summary, in-home care assistance is sometimes covered by Medicare, but only if you also need skilled nursing or medical services besides personal care.

It gets so confusing. Give your local Home Care Assistance office a call today. While Home Care Assistance is private pay (meaning we do not accept Medicare), we can help you decipher what type of care is appropriate and how to best cover the expense.  Contact your local Greater Burlington office today!