Are You Eligible for Medicare’s Home Health Benefit?

November 5th, 2020

Did you know that you may be eligible to receive home health services through Medicare? Under Part A, which is the component of Medicare that covers hospital care, you may be able to take advantage of home health services. 

What is Medicare’s Home Health Benefit?

Though you can receive care at home, this is not full-time care. The home health benefit includes part-time or occasional home services, which can include things like: 

  • Skilled nursing care
  • Speech-language pathology
  • Physical therapy
  • Occupational therapy
  • Health aide services
  • Medical social services

Medicare can also help beneficiaries receive necessary medical equipment such as walkers and wheelchairs for home use. 

Who can receive the Medicare Home Health Benefit?

As with most medical services, you must meet certain standards to receive this type of care. A beneficiary must:

  1. Receive care from a physician. This physician must also provide a care plan explaining why the patient needs home health care and what services they need.
  2. Attend an in-person visit with a physician, nurse practitioner, or physician’s assistant. This is so the doctor can determine whether you need these services.
  3. Be determined homebound. This is defined as being unable to leave your home without “considerable and taxing effort.” A physician must make this determination.
    Additionally, you must require help from medical equipment or another person to leave your home OR have a condition that does not permit you to leave your home.
  4. Need part-time skilled services. These include the home services listed above. However, needing full-time home care makes beneficiaries ineligible for the Medicare Home Health Benefit.
  5. Get a recertification every 60 days. The initial care period lasts 60 days. Not everyone needs more care than this. Those who do have to be recertified by a physician. A physician can recertify any number of care periods as long as the beneficiary meets the above standards.

Medicare does not cover prescription drug services or non-medical services such as transportation and housekeeping.

Ready to find your 2020 Medicare plan? Head over to our Medicare center to compare plans and find the right coverage!

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