Does Medicare Cover Home Health Care?
Teton Medicare • July 12, 2023

July 12, 2023


home health agency w/durable medical equipment


Yes,  Medicare  covers home health services, as long as they are not long-term care.  The services Medicare does cover include part-time skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medical social services, part-time home health aide services, and injectable osteoporosis drugs for women.



Home Health Care



Home health care is any care services received in the home.  This may be physical, occupational, rehabilitative, or otherwise. Some of the primary providers of home health care are home health aides and skilled nurses. If you are in need of rehabilitation services, you may have the services of multiple therapists to restore you to proper function.



Home Health Care Covered Services



Medicare Part A and Part B medical supplies  cover many home health services. These services include part-time skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medical social services, part-time home health aide services, and injectable osteoporosis drugs for women.



The important distinction here is the part-time nursing.  Medicare does not cover long term, full-time care.  This is often called custodial care or long term care.



Medicare Costs for Home Health Care



Your coverage for home health care will largely fall under Medicare Part B as outpatient services, unless you receive mostly skilled nursing assistance, which would fall under Medicare Part A.  Medicare does not cover the full cost of these services.  You have to pay your out-of-pocket costs just as if this were a doctor or outpatient hospital visit.



Medicare Part A costs include the deductible, coinsurance and copayments. The deductible for inpatient, skilled nursing facility care is $1,484 for each benefit period, which is the time between being admitted as an inpatient and when you have not received inpatient care for 60 days. If you spend more than 20 days in a skilled nursing facility, you will have to pay a daily coinsurance of $185.50.



Long Term Care



home health care services & intermittent skilled nursing careLong term care involves assistance with the daily motions to function as a human person. That means what are called the activities of daily living (ADLs), some of which include feeding yourself, bathing, using the restroom, and getting dressed. Medicare does  not  cover long term care in a skilled nursing facility or at home. The custodial care you receive is  not  covered by Medicare when that is the only care you need.



Paying for Full Time Home Health Care



The monthly cost for home health care services is around $4,000 in Idaho. Many people turn to long term care insurance to help them afford their home health care without having to sell their home. Most times people have to liquidize their assets to afford long term care. If you have a low income and limited resources, Medicaid may be able to cover this care.



Affording Home Health Care



Teton Medicare is here to help make sure you can afford all of the services you need to function every day. Home health care is one of those services that provides invaluable skill and support. For what  Medicare  doesn’t cover, we can help you find long term care insurance. Contact us today to find a plan that suits you.


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