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Does Medicare Usually Cover In Home Care?

By , 11:21 am on

What are you to do when you’re released from the hospital but need assistance at home? You need to know if your Medicare will cover in-home care, but the correct answer is it depends.

It depends on whether you may need specialized therapy, skilled nursing care, or medical equipment and supplies as you are ill or recovering from illness or surgery. In the best scenario, Medicare will pay for your recovery at home, rather than in a nursing facility, but it doesn’t cover all types of in-home care or on every occasion.

Know the difference: Medical vs. non-medical care

Before you make a call for in-home care, know the difference between medical and non-medical in-home care. Knowing this difference will help you understand whether you’re likely to be covered by Medicare or not.

Medical care: Medicare may cover in-home care if your doctor prescribes it. Skilled nursing, medical care, like physical rehab, administration of medicines, or medical-social services are all often covered. Medical equipment is provided at times, too.

Non-medical care: If the doctor prescribes only non-medical care, Medicare won’t cover it. Non-medical care would be help with hygiene, dressing, exercise, meal prep, light housekeeping, running errands, transportation, buddy calls, or safety checks. These services are often necessary, but usually not covered by Medicare.

When does Medicare pay for in-home care?

Medicare typically covers medical services and in-home care when specific conditions are met:

  1. The doctor must accept Medicare.
  2. Special medical equipment is needed before you can leave your home.
  3. The doctor orders in-home care for non-permanent skilled nursing in-home care.
  4. The doctor has been seen and confirmed that medical in-home or skilled nursing care is necessary.

Once again, your in-home care is likely to be covered by Medicare when skilled nursing services or specific medical supplies are necessary for recovery, but it doesn’t cover non-medical or “personal” needs.

How Home Care Assistance of Fort Worth Can Help

Home Care Assistance Fort Worth is a private pay in home care provider, meaning we do not accept Medicare. Most home care services are excluded from Medicare coverage, so we are dedicated to finding an affordable, flexible care plan that is right for your loved one. Contact us today to learn more about your in home care options.