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How often is it covered?

Medicare part A(hospital insurance) and/or Medicare part B (Medicare insurance) covers eligible home health services like intermittent skilled nursing care,  physical therapy,  speech and language pathology services, continued occupational services and, more usually, a home healthcare agency coordinates with services your doctor orders for you.

Medicare does NOT pay for:

  • 24 hours a day at home care
  • Meal delivery to your home
  • Homemaker services
  • Personal care/custodial care

Who is eligible?

All people with Medicare who meet all of these conditions are covered:

  • You must be under the care of a doctor and you must be receiving services under a plan of care established and reviewed regularly by your doctor.
  • You must need, and a physician must certify- that you require one or more of these:
    1. Intermittent skilled nursing care.
    2. Physical therapy, speech language pathology or continued occupational therapy services.
    3. The home health agency caring for you must be Medicare certified.
    4. You must be HOMEBOUND and a doctor must certify to that effect.

You’re not eligible for the home health benefits if you needed more than part-time or INTERMITTENT skilled nursing care. However, you may leave your home for medical treatment or short, infrequent  absences for non-medical reasons like attending religious services.  Also, you can still receive home health care if you attend adult daycare.

Your costs in original Medicare:

  • $0 for home Health services
  • 20% of the Medicare approved amount for durable medical equipment (DME)

Note: Home health services may also include medical social services, part time or intermittent home health aide services, medical supplies for use at home, and durable medical equipment.

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