Medicare Made Simple
Briefly, Medicare is a Government sponsored and mandated health care program for Americans 65 years and older. (This age may be revised as part of the larger, National Health Care/Entitlement debate).
Currently it breaks down like this:
Medicare A pays 80% of Hospital, Rehabilitation Center or Hospice stays. Hence people often by a supplementary policy to cover the remaining 20%. Only the Medicare Home Health benefit is covered at 100 percent.
Medicare B pays 80% of a Doctor Visit or Outpatient Physical Therapy. Again, many people purchase a supplementary insurance policy for the balance.
Medicare D is the prescription drug program under Medicare. You would need to look at the different plans under the program to judge which is most cost effective for you based on the medications you are prescribed.
Does Medicare Pay For Home Health Care?
Probably the most frequently asked question I hear is: “Does Medicare pay for it?” The “it” being home care. The answer is “yes, but”.
Medicare does in fact currently pay at 100% for home visits by a:
- Registered Nurse
- Physical Therapist
- Occupational Therapist
- Speech Therapist
- Medical Social Work
- Aides for bath visits
All assistance is on a “visit” basis, they do not stay after the task is performed. All but the bath visit are considered “Skills”.
The RN (registered nurse) will do an evaluation and can order the other Skills. You can not receive a bath visit without having a need for at least one of the other Skills.
What Doesn’t Medicare Pay For?
However, Medicare does not pay for a caregiver or aide who assists with either personal care and/or homemaking. This is a private duty caregiver who stays with the client for longer than a “visit”. Usually the home health aide stays for at least a few hours, a few days a week or even as a live-in caregiver. This service is usually paid for either by the client’s Long Term Care Policy or out of pocket, privately.
Find Out More Information About Medicare
Please visit www.medicare.gov for more detailed information. You may visit www.medicarecompare.gov to view ratings of Medicare certified agencies in your area. As part of our Elder Care services, we do have a sister Medicare certified agency that can answer your specific questions. Visit www.bocahomecare.com or call 561-989-0441 to speak to one of our nurses.