Philadelphia’s Trusted Home Health Care Agency

Navigating the world of health insurance coverage can be complex, especially when it involves understanding what services are covered under Medicare for home health care. At Right Aid Home Care, we frequently encounter clients seeking clarity on this very topic. It’s crucial for seniors and their families to understand the extent of Medicare coverage to make informed decisions about their home health care needs.

What is Home Health Care?

Home health care encompasses a wide range of health and supportive services delivered in the comfort and privacy of one’s home. These services are typically designed for individuals who are aging, recovering from medical setbacks, dealing with chronic illnesses, or have disabilities. Home health care can include medical care, such as nursing and physical therapy, as well as non-medical services like personal care and companionship.

Medicare Coverage for Home Health Care

Medicare, the federal health insurance program for people who are 65 or older, does provide coverage for certain home health care services. Understanding this coverage is key to accessing necessary care without undue financial burden.

1. Medicare Part A and Part B Coverage

Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) can cover certain in-home health care services, but specific conditions must be met. These include:

• A doctor’s certification that you need intermittent skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy.
• The home health care agency being Medicare-certified.
• The patient being homebound, meaning it’s extremely difficult for you to leave your home and doing so requires a considerable and taxing effort.

2. Services Covered by Medicare

If you meet the above criteria, Medicare can cover:

• Part-time or intermittent skilled nursing care.
• Physical therapy, speech-language pathology services, and occupational therapy.
• Medical social services.
• Part-time or intermittent home health aide services (personal hands-on care).
• Injectable osteoporosis drugs for women.

It’s important to note that Medicare does not cover 24-hour-a-day care at home, meals delivered to your home, and services unrelated to your care plan, like cleaning and laundry.

3. Medicare Advantage Plans (Part C)

Medicare Advantage Plans, offered by Medicare-approved private companies, must cover all the services that Original Medicare covers. Some may offer additional benefits, which can include broader home health care services.

4. Payment and Costs

Under Original Medicare, you typically pay nothing for covered home health care services. However, you may have to pay 20% of the Medicare-approved amount for durable medical equipment.

Contact Our Home Health Care Agency in Philadelphia Today

Medicare can be a valuable resource for covering home health care costs, but it’s essential to understand the specifics of your coverage. At Right Aid Home Care, we recommend consulting with your healthcare provider and reviewing your Medicare plan to determine what home health care services are covered for you or your loved one. As a provider of comprehensive home care services, we are here to assist you in navigating these options and ensuring you receive the care and support you need. Contact us today to learn more!