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Medicare Homecare Regulations

Medicare is a service that is provided by the United States government to help cover the costs of medical treatments and services for those who are not able to afford them. Senior citizens pay into a Medicare fund through taxes, which can later pay for home health services in the event that they have to temporarily be cared for in their own home.

  1. Plan of Care

    • Physicians must provide a plan of care to the Medicare organization. The plan of care must provide all information relevant to the patient's condition, the type of services that must be provided to the patient, who will provide the service and how long the service is supposed to be provided, according to Senior Law, a website devoted to providing information on senior legal issues. All of these orders must be signed before the medical services bill is sent to the Medicare office.

    Patient Recovery

    • Medicare is primarily designed to cover acute care rather than covering long-term care. In other words, Medicare is provided with the expectation that the patient will recover and will no longer need home care, according to PubMed Central, a free digital archive created by the U.S. National Institutes of Health.

    Services Provided

    • To receive home care, a physician must certify that there is a need for such home care. The physician must certify that the patient needs nursing home care, physical therapy, speech-language pathology services or occupational therapy, according to PubMed Central. The physician must also certify that the patient is homebound. Usually, patients become homebound when leaving their home becomes difficult due to physical ailments.

    Home Healthcare Organization

    • Medicare must approve of the home healthcare organization. If an organization providing home healthcare services is unable to continue providing these services, the organization must tell the patient how the he can continue to receive these services from other organizations. The organization must be capable of meeting all of the patient's needs, according to the Department of Health and Human Services. Medicare will cover skilled nursing care by a registered nurse, physical therapy, medical social services and home medical supplies. Medicare does not pay for 24-hour home care, meal deliveries, homemaker services or personal care.

    Time Period

    • Medicare pays for 60 days worth of a home care health service. Some percentage of Medicare equipment costs have to be paid by the patient or some other source, according to the Department of Health and Human Services. The number of hours that a patient receives in home care is based on the patient's needs.

    Appeals

    • If a Medicare recipient believes that a particular service should be provided, that recipient has the right to appeal a decision. While appealing a decision, the patient should check with her healthcare professional to see if the professional can provide information that can help her appeal the case, according to the Department of Health and Human Services.

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