Understanding Your Medicare Home Care Benefits

Home » Understanding Your Medicare Home Care Benefits » Home Health Care » Understanding Your Medicare Home Care Benefits

Medicare Home Health Care Explained

For many caregivers and families who are searching to find out more information on how they can care for their elders and loved ones, it can seem like a daunting task. One of the most important distinctions that have to be made on your information gathering quest is to know the difference between Medicare covered Home Care vs. all other forms of home care. In this article, we will explain what Medicare Home Health Care is and how to find out if you or your loved one qualifies.

What is Medicare Home Health Care?

Home Health Care is skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury.

One of the services offered to senior citizens by Medicare is Home Health Services. Medicare recipients must qualify for services, and they must be recommended by the individual’s primary care physician or specialty care physician.

Medicare beneficiaries who feel they may need Medicare home care should always look into whether they can actually qualify for Medicare home health services. It is not a general personal care or chore-worker service. Rather, Medicare home care covers limited, specifically defined at-home care related to diagnosed medical conditions, and sometimes includes personal care services.

These Medicare home health services must be prescribed by a physician, and provided through a licensed home health agency. The beneficiary must have a medical condition, or combination of conditions, that require periodic services from a skilled nurse or therapist. A plan of care will be developed that describes the specific services covered. Eligibility and coverage are evaluated strictly so the beneficiary’s conditions and care needs must be aired fully.

Medicare Home Health Care Qualifications

It is common for an elderly person to need assistance upon discharge from a hospital or in-patient rehabilitation stay. That individual’s physician, sometimes in concert with family members and the patient him/herself, would determine the in-home health care need and complete paperwork that refers the patient to home health care.

Other common situations include the slow physical decline elderly people experience; when that decline includes inability to care for oneself on a daily basis—but nursing home care is not yet required—the physician may recommend home health care for just those tasks the senior is unable to perform.

These four conditions must be met before home health services can be prescribed and covered by Medicare:

1. Your doctor must decide that you need medical care in your home, and make a plan for your care at home; and
2. You must need at least one of the following: intermittent (and not full time) skilled nursing care, or physical therapy or speech-language pathology services or continue to need occupational therapy; and
3. You must be home bound or normally unable to leave home & leaving home takes a considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons; and
4. The home health agency caring for you must be approved (“certified”) by the Medicare program.

To find answers to your other questions like:

What Does Medicare Home Health Care Include?

What is a Medicare Home Health Doctor Care Plan?

What Rights Do I have In Choosing My Home Health Provider?

What Does Medicare Home Health NOT Cover?

Please visit Boca Home Care’s Understanding Your Medicare Home Health Benefits page. We hope this information will make your quest a little easier.

If you have any Elder Care information or resources that you believe can help our readers, we’d love to share them. Become a Guest Blogger. For more information, contact us.

  1. stuck in the moment lyric June 15, 2010 at 8:34 pm

    Hey this is a great post. I’m going to email this to my friends. I stumbled on this while surfing for some lyrics, I’ll be sure to come back. thanks for sharing.

  2. Debbie Mccready July 3, 2010 at 6:49 pm

    Thanks for the captivating article, may I ask where you get your information from?

  3. Hal Kangas July 4, 2010 at 12:08 pm

    I didn’t realize it was possible to go into so much detail, thanks again!

  4. Jackie Tayler July 9, 2010 at 6:27 am

    I just wanted to comment and say that I really enjoyed reading your blog post here. It was very informative and I also digg the way you write! Keep it up and I’ll be back to read more in the future

  5. Jonathan Faivre July 14, 2010 at 1:15 pm

    It is a genuinely well thought out post. I certainly enjoyed reading it. Thanks

  6. Pingback: Elder Care Provider – A Synonym Of New Life For Senior Citizens - I Submit Now

  7. Pingback: Senior Care ‘ | Find Assisted Living In Orange County CA and the Surrounding Southern California Area

  8. Pingback: Senior Care ‘ | Find Assisted Living In Los Angeles CA

  9. Dan Fisher RN, BSN August 4, 2011 at 10:30 am

    Great article that shows you are more than familiar with the Medicare Conditions of Participation. Thanks again.

  10. Julie Rawat October 26, 2012 at 1:18 am

    The, “Understanding Your Medicare Home Care Benefits” blog is very nice, be continue for making perfectblog, Thank you so much for posting it!

  11. admin December 18, 2012 at 10:57 am

    Thank you, we do try to be helpful and provide valuable info. thanks for your comment

  12. absolute home health care March 6, 2014 at 5:45 am

    I was confused between home health care and medicare health care services. After reading your post i can suggest anyone about home health care or medicare health care services.