Does Medicare Cover Home Health Care?
Medicare does cover home health care as long as it is deemed medically necessary by a doctor.
A Medicare Supplement (Medigap) plan can help cover your home health care Medicare costs, which can include out-of-pocket costs like deductibles, coinsurance, copays and more.
When Does Medicare Pay for Home Health Care?
Many health care services that were once only available in a doctor’s office or hospital are now available at your home. This form of care, known as home health care, can encompass a wide range of treatments and services.
Original Medicare (Part A and Part B) covers care at your home in certain circumstances, including:
Intermittent skilled nursing care (less than seven days a week; or less than 8 hours a day over a maximum of 21 days)
Speech-language pathology care
- Medical social services
Once your doctor refers you to a home health care agency, the agency will come to your home and administer care as often as directed by your doctor. The home health agency will also regularly update your doctor on your progress.
To receive skilled nursing care at home, you must be homebound and not require full-time care.
How Much Does Home Health Care Cost With Medicare?
Typically, the costs of home health care services covered by Original Medicare are as follows:
$0 for home health care services
20% of the Medicare-approved amount for durable medical equipment
Keep in mind that you are still responsible for your Original Medicare out-of-pocket costs, which include your Medicare Part A and Part B deductibles, coinsurance and copays.
How Do I Start Getting Home Health Care?
Before you begin receiving home health care, your home health agency will schedule a time to visit your home.
During this appointment, you’ll discuss your health care needs, and you’ll have the opportunity to ask questions about your health care services. The home health agency will also talk with your doctor about your care to ensure everyone is on the same page.
Once treatment begins, your home health care provider will also:
Ask about the food you eat
Check your vital signs (blood pressure, temperature, heart rate, and breathing)
Discuss with you the medications you’re taking
Teach you about any steps you need to take in order to stay healthy
Medicare Covers Skilled Nursing Facility Care
If a beneficiary is an inpatient at a skilled nursing facility (SNF), Medicare may provide coverage for up to 100 days for the cost of:
- Semi-private rooms
- Physical and occupational therapy
- Speech and language pathology services
- Ambulance transportation
- Other services and costs
A daily coinsurance fee of $204 (for 2024) is charged beginning on day 21 of an inpatient stay at a skilled nursing facility.
Find Medigap Plans That Help Cover Your Home Health Care
If you home health care that is covered by Medicare, you may likely face out-of-pocket Medicare costs such as deductibles, coinsurance and copayments.
A Medicare Supplement Insurance plan can help cover some of these costs.
For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered home health care.
Learn more about Medicare coverage of common procedures
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.