Medicare & In-Home Health

Many elderly people as well as those recovering from serious illnesses or injuries prefer to receive health care services in the comfort of their own homes rather than nursing homes or other medical facilities. Medicare Part B covers some in-home health care services under certain circumstances. You do not have to pay for most in-home health care services if you have Medicare Part B. Many Medicare Advantage Plans, also known as Medicare Part C, cover in-home health care services as well but coverage varies from plan to plan. You may have to pay part of the cost for home health services yourself. If you have a Medicare Advantage Plan, call the number on your insurance card for specific information about your coverage.

Skilled Nursing Care

• Medicare only covers in-home health care services if you require skilled nursing care such as the administration of intravenous medications, dressing changes or carefully monitoring of a serious medical condition like Alzheimer's disease or diabetes. For Medicare to cover your home health care services, your condition must confine you to your home most of the time.

Home Health Aide Services

• Medicare Part B covers home health aide services if you need skilled nursing care as well. Medicare only pays for home health aide services like assistance with personal care such as bathing and dressing and help with ambulation or transferring to and from a wheelchair. Medicare does not cover homemaking services like housekeeping, laundry or meal preparation. However, if you need homemaking services, you may be able to get those services from the same home health aide that Medicare pays to provide your personal care if you have other funding sources.

Therapy Services

• Medicare Part B also covers in-home physical therapy, occupational therapy and speech therapy when medically necessary.

Durable Medical Equipment

• Medicare Part B pays for durable medical equipment needed for use in the home when that equipment is medically necessary. In some cases, Medicare pays to purchase equipment, while in other cases it pays to rent equipment. Examples of durable medical equipment covered by Medicare include walkers, wheelchairs and hospital beds.

Getting Coverage

• To get in-home health care coverage from Medicare, your physician must order home health care services, and the services must be medically necessary. Your physician must write an order for any medically necessary durable medical equipment, as well. Medicare only covers durable medical equipment rented or purchased from authorized suppliers so check before you order equipment to make sure it will be covered.