Homebound Medicare Guidelines

When you reach retirement, the U.S. government not only provides you with retirement income due to Social Security taxes you have paid, but also helps you to access cheap health insurance plans through Medicare. Medicare is the federal government health insurance program for senior citizens and disabled people. If you have paid Medicare tax, you are eligible to receive premium-free hospital insurance. Otherwise, you may buy it if you so desire.

Homebound

• "Homebound" means that you are not able to leave your house without undergoing a major effort due to your health conditions. It mostly applies to people who need home health care because their condition is so severe and long-term that leaving home is difficult and very expensive. It also means that your doctor recommends that you not leave your home due to your health, and that doing so can actually worsen your condition. You are allowed to leave your home for medical purposes, such as visits to the doctor, and some nonmedical purposes, such as going to church. Being homebound is a requirement for activating one of the coverages provided by Medicare: the home health care coverage. Your doctor must certify that you are homebound.

Medicare Part A

• Medicare Part A, which is hospital insurance, is the basic coverage that Medicare offers. Social Security tax revenue is used to fund this coverage if you paid it when you were working. Medicare Part A coverage includes hospital inpatient stay, hospice care, home health care and skilled nursing facility care. The home health care coverage provided through Part A applies only if you are considered a homebound individual, meeting all of the above requirements.

Medicare Part B

• Medicare Part B, which is medical insurance, is another part of basic Medicare coverage. However, unlike Part A, Medicare Part B requires monthly payments for its coverage. Part B coverage includes visits to the doctor, preventive care and home health care coverage. As with Part A, a requirement to activate home health care coverage on Part B is for you to be homebound.

Other Conditions

• In addition to being homebound, you must be in need of skilled nursing care. Since you cannot leave home, Medicare pays to provide these services at your home. Your doctor must not only certify you are homebound, but she must also certify that you are in need of medical care at your home. However, your doctor can only do so after a Medicare doctor sees you and orders your care. You must get your care through a Medicare-approved agency, or Medicare will not pay for it.