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Does Medicare Cover Home Health Aides?

Does Medicare Cover Home Health Aides? Sometimes you may find that you need help at home to perform daily tasks due to a health problem. Home health care can include dressing, preparing meals or bathing, or taking more medical care, such as changing dressing on a wound. Medicare insurance coverage for home health assistants is generally limited and temporary. Let’s go into more details below.

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How does Medicare cover home health care?

Medicare Insurance Part A (Hospital Insurance) and/or Part B (Medicare Insurance) may cover home medical assistants if your doctor orders such care and determines that it is medically necessary. Usually, Medicare insurance does not cover a full-time and long-term home health assistant. Attention should be part-time and paid from time to time — not constant.

Here’s the kind of home Medicare services Medicare may cover:

  • Part-time or Intermittent
  • Part-time or Intermittent Assistant Skilled
  • Part-time or Intermittent Nursing
  • Physical Therapy and/or Occupational Therapy
  • Speech Language Pathology Services
  • Medical Social Services Certain Durable
  • Medical Equipment and Supplies, in some cases

Does Medicare Cover Home Health Aides?

 Who may be eligible for home health aides under Medicare?

Medicare insurance has coverage rules for home health assistants. Here are some of them (this may not be a complete list): You should be in the care of a doctor with a plan of care that your doctor reviews regularly.

You must be at home, as certified by your doctor. OHIP believes that you cannot leave your home without help, or your condition usually requires you to stay at home.

You can always call “at home if you go to religious services, doctor appointments or adult daycare.

Your doctor must certify that you need at least one of the following:

Intermittent specialized nursing care (in addition to blood sampling) Physical therapy, speech therapy and speech therapy, or continuing occupational therapy services.

You can consult Medicare (or your Medicare Advantage Plan, if you have one) about the specific rules for these types of therapy and the amount of coverage.

What home health services are not covered by Medicare?

Usually, health insurance does not cover home health assistant services if the only care you need is “custody”.

Childcare does not require medical skills. It is about care such as dressing or helping bathe, eat or use the bathroom. Here are some examples of childcare.

Please also note that:

Housewives services, such as shopping or laundry, are generally not covered by Medicare insurance. Medicare does not cover meals delivered to your home. If you need 24-hour home care, health insurance usually does not cover it.

How much do home health services cost?

If you are eligible for Medicare insurance for your home health care, you usually do not have to pay for it. If you need durable medical equipment, you usually pay 20% of the amount approved by Medicare. Keep in mind, however, that your doctor may request more home health care services for you than Medicare will.

If you have any questions, ask your doctor or call Medicare at the bottom of this page.

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Getting home health services in certain states

If you live in Massachusetts, Michigan, Florida, Illinois or Texas, a Medicare demonstration program may apply. As part of the program, you (or your home health care provider) may request a pre-application review. This exam can tell you from the outset whether Medicare is likely to cover your home health services.

If you are a resident of one of these states, you can request a preliminary review of the application as soon as your doctor orders home care so that you know if you will have to pay anything. Do you have questions about Medicare insurance coverage options? You can compare the Medicare insurance plan options by entering your postal code and clicking the button on this page.

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