How to Use Medicare for Home Health Care
After a hospital stay, surgery, or change in your health, the best place to recover is often your own home. Many people don’t realize that Medicare can cover the cost of professional care during this time, helping you get stronger and avoid rehospitalization.
However, the rules are specific. This guide explains what Medicare’s home health benefit includes, the key requirements you need to meet, and how we make the process simple.
Skilled Services Covered by Medicare
Medicare’s benefit is designed for short-term, skilled care ordered by your doctor to treat an illness or injury. It can include:
- Part-time or intermittent skilled nursing from an RN or LPN.
- Physical, occupational, or speech therapy to help you regain function.
- Medical social services to help you with the social and emotional aspects of recovery.
- Home health aide visits for personal care, but only if you are also receiving skilled nursing or therapy.
- Certain medical supplies and durable medical equipment (DME).
Key Requirements & Limitations
To use your Medicare home health benefit, you must meet a few important criteria. We help you and your doctor document these.
You Must Be “Homebound”
This is a key requirement. It doesn’t mean you can never leave home, but it does mean leaving takes a considerable and taxing effort, often requiring assistance.
You Need a Doctor’s Order
A doctor must certify that you need skilled care and create a plan of care for you.
What Medicare Does Not Cover
It is important to know that Original Medicare does not pay for:
- 24-hour care at home.
- Meal delivery services.
- Homemaker or cleaning services.
- Personal or custodial care (help with bathing, dressing) if that is the only care you need.
What About Medicare Advantage Plans?
If you have a Medicare Advantage (Part C) plan from a private insurer, your benefits might be different. Many of these plans offer additional benefits not covered by Original Medicare, such as extended personal care. WeCare partners with most major Medicare Advantage plans in our service area.
Our Simple 3-Step Process to Start Care
- Eligibility Check: Contact us and we will verify your Medicare benefits and confirm you meet the requirements.
- Doctor Coordination: We work directly with your physician’s office to get the required orders and establish your official plan of care.
- Your Care Begins: Your skilled nurse or therapist will schedule their first visit to your home to begin treatment.
