Many seniors will require in-home care services, whether it be in-home skilled nursing or physical therapy. Suppose you are receiving in-home care or need in-home care as a Medicare beneficiary. In that case, you may be wondering if Medicare covers this service for you. There are many aspects to in-home care, and this article will detail the different types. If you’re wondering if Medicare covers these services and which types are covered, keep reading!
Will Medicare Cover My Skilled Nursing Care?
Skilled nursing care is used to assist in the recovery of an injury or to treat an illness. This involves medical treatment, such as catheter changes, tube feedings, wound dressings, and injections. Medicare will pay for it if skilled nursing care is provided for 21 days less than seven days a week or every day less than eight hours per day. Medicare will not, however, pay for 24 hours a day of care.
Will Medicare Cover My Occupational, Physical, or Speech Therapy?
When patients regain their movement or strength after an illness or injury, Medicare will pay for the physical therapy costs. If patients are restoring functionality, then Medicare will pay for the occupational therapy costs. In addition, patients who are regaining the ability to communicate through Speech Pathology will have their expenses covered by Medicare.
In all the above cases, Medicare will only pay for these costs if the patient is expected to improve in a predictable and reasonable amount of time. A skilled therapist is medically needed to treat the patient back to health.
Will Medicare Cover My Durable Medical Equipment?
If you have medically necessary equipment prescribed by your doctor for in-home use, Medicare will cover that. The included items that Medicare will pay for are wheelchairs, walkers or canes, oxygen, nebulizers, hospital beds, and blood sugar monitors. When it comes to durable medical equipment, patients will pay 20% of the amount and any deductible remaining for Part B.
Medicare Coverage of Medical Social Services
Patients going through the emotional aftermath of an illness or injury can receive medically prescribed services that help patients cope and Medicare will cover it. These medical social services include in-home counseling from a social worker or licensed therapist. Medicare will, however, only cover these services when patients are receiving skilled nursing care.
Who is Eligible for In-Home Care?
Medicare beneficiaries who have Original Medicare, Parts A, and B, are eligible for in-home care services if the following requirements are met:
- The patient’s doctor reviews the treatment plan regularly
- The patients’ skilled nursing care or therapy has been certified by a doctor
- Physical, occupational, and speech therapy must be for a limited time
- A doctor verifies that the patient is homebound
- Skilled nursing only needs to be intermittent or part-time
- The in-home care agency is Medicare-approved
Medicare-covered services will apply if you receive them for a limited time and are approved by a doctor. There is a wide range of in-home nursing care that you can get covered by Medicare. It is not just limited to skilled nursing care – but also includes in-home occupational therapy, physical therapy, and speech therapy.
Medicare also covers doctor-prescribed durable medical equipment as well as medical social services. To be eligible for in-home care, you must have a doctor reviewing your treatment plan, certified nursing care or Medicare-approved therapists, verification from a doctor that you are homebound, and skilled nursing that is intermittent or part-time. When getting your in-home care services set up, make sure that your doctor and Medicare approve your services to avoid billing troubles in the future.