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Senior Health

 

How Medicare Covers In-Home care

Jim T. Miller

Medicare covers a wide variety of intermittent in-home health care services (usually up to 28 hours per week) to beneficiaries if you meet their specific requirements. Here's how it works.

In order for you to secure coverage for home health care, Medicare first requires that you be homebound. This means that it must be extremely difficult for you to leave your home, and you need help from a device (like a wheelchair or walker) or a person in doing so.

You will then need your doctor to approve a "plan of care" confirming that you need skilled-nursing care or skilled-therapy services from a physical or speech therapist on a part-time basis. Your doctor can also request the services of an occupational therapist and a home health aide to assist with activities of daily living such as bathing, dressing and using the bathroom. Your doctor must renew the "plan of care" once every 60 days.

You will also need to use a home health agency that is certified by Medicare.

If you meet all of the requirements, Medicare should pay for your in-home care.

But, be aware that Medicare will not pay for home health aide services (such as bathing, dressing or using the bathroom) alone if you do not need skilled-nursing or skilled-therapy services too. Homemaker services, such as shopping, meal preparation and cleaning are not covered, either.

You also need to know that Medicare has recently changed their home health care policy regarding degenerative diseases. They will now pay for in-home physical therapy, nursing care and other services to beneficiaries with chronic conditions like multiple sclerosis, Parkinson's or Alzheimer's disease in order to maintain their condition and prevent deterioration. In the past, Medicare would only cover home health services if the patient were expected to make a full recovery.