Does Medicare Pay for Home Health Care?

You can apply for Medicare, 3 months before your 65th birthday. Medicare covers the cost of many medical and healthcare needs from doctor visits to hospital stays. However, it does not offer or support long term care program, in assisted living or home.

If you are on Medicare, you could still be eligible for long term care programs through Medicaid. Learn more about dual eligibility and how you can apply for it.

Understanding Medicare: Part A and Part B

Medicare is a federal funded health insurance for people who are 65+. Some people with disabilities, and those who are in the final stages of renal (kidney) disease can qualify at a younger age. Original Medicare consists of two parts which covers basic medical and health expenses.

What does Medicare Part A cover?

Part A covers major health expenses like hospital stays, skilled nursing, or some short-term care. It covers the hospital stay, meals, medications during the stay, lab tests, and surgeries.

It covers hospice services that includes counseling, medication, pain management, and care related to your conditions. It can also pay for skilled nursery care after a hospital stay of at least 3 days. It can cover home health care for those days that includes physical therapy, visiting nurse, and medical supplies.

The monthly premium for most people is $0, where the annual deductible is $1676 per benefit period.

What does Medicare Part B cover?

Part B covers the majority of the healthcare spending that includes doctor's visits, preventive services, medical equipment, ambulance services, outpatient surgeries, diagnostics tests, and mental health services.

The preventive care is covered at no cost, no deductible, and no coinsurance. This includes annual physical exams, vaccinations, diabetes screenings, and preventive tests. It can also cover part of wheelchair, hospital beds, and oxygen equipment costs.

Does Medicare pay for Home Health Care?

Self-directed home health care empowers individuals to manage their health with the help of family or a professional caregiver. Medicare however does not cover long term home care or personal care or compensate family caregivers. This is where Medicaid comes in.

Long Term Care Program: Medicaid and Medicare

If you need care because of chronic conditions or a disability and prefer to age at home, Medicaid home health care programs can help cover the cost of it. While Medicare covers short-term care that is needed after a hospital stay, Medicaid can help pay for long term care and the caregiver you have chosen.

If you are on Medicaid and Medicare, you could still qualify for the program. Medicaid is funded and managed by the state, so the eligibility requirements are different for every state, and it is known by different names. Some programs are PCS in Nevada, CDS in Missouri, or CDPAP in New York.

Can you qualify for Medicaid and Medicare?

A simple answer would be yes! If you are enrolled in Medicare but if you have limited income, you could also be eligible for Medicaid. People who have both or qualify for both Medicare and Medicaid are dual-eligible beneficiaries.

According to the Centers for Medicare & Medicaid Service, you may qualify for dual eligible benefits if:

• You are enrolled in Original Medicare,

• You get Medicare out-of-pockets costs through Medicare Savings Program, or

• You receive full Medicaid benefits

Medicare eligibility is based on age so if you meet the requirements for it, you can enroll regardless of income. Learn the eligibility requirements and how to apply for Medicaid in your state. The dual eligibility depends on the income limits for Medicaid, and every state has different income requirements.

Need Help Applying?

If you are enrolled in Medicaid, you can contact BURD Home Health and we will be happy to guide you through the process of enrolling your state's home health care program. Health coverage is always possible, so apply today and take the first step towards taking control of your healthcare.