Does Medicare Cover Home Health Care?

Struggling with the basic necessities of a daily life can be taxing for the elderly who suffer physical ailments, and it can be immobilizing to the disabled. The cost of home health care is staggering, and many find themselves financially unable to afford the type of care they require. There is a wealth of government-assisted programs available, yet determining which you or your loved one is eligible for can be a frustrating experience, especially if you learn you are ineligible for a program you've already spent the time applying to.

What is Medicare?

Medicare is a federal insurance program for American citizens who are of 65 years of age and older. Medicare will also cover those who are physically disabled. Americans are automatically enrolled into Medicare upon their 65th birthday. It is used to provide affordable health care to those who are either disabled or eligible for Social Security and otherwise could not afford it without incurring a severe amount of debt. It also assists with offsetting the cost of health insurance, which increases drastically the older one gets.

What does Medicare Cover?

There are multiple tiers of Medicare coverage:

Medicare Part A is for hospitalization.

Medicare Part B will cover various outpatient services, including checkup visits, physical therapy, and occupational therapy. It can also cover various preventative procedures.

Medicare Part C is a private plan that gives Medicare recipients an alternative to Parts A and B. However, it comes at an additional cost, but may provide a heightened level of care.

Medicare Part D covers prescribed medications as a prescription drug plan would.

Does Medicare Cover Home Health Care?
If you've read the list, you will have noticed that "home health care" does not fit into the Medicare equation. While Medicare covers a various list of services, it will not cover hospice or nurse visits at your home.

What Other Options Do I Have?
Fortunately, a separate federally assisted program exists that does cover home health care: Medicaid. While Medicare is blanket health insurance to cover American citizens over the age of 65, Medicaid was designed specifically to provide medical assistance to low-income individuals including those younger than 65. Unlike Medicare, which is a solely federal-funded program, Medicaid is joint-funded by both the federal government and your state government. Your state will provide the necessary testing to determine whether or not you are eligible.

What does Medicaid Cover?
Medicaid covers various expenses incurred at the hospital in addition to outpatient services, such as doctor visits. Medicaid also covers nursing home care and other long-term care, such as at-home care. Medicaid does not cover prescription medication, but the majority of those eligible for Medicaid are also eligible for Medicare Part D.

Who do I Contact about Medicaid?
To determine if you or your family member is eligible for Medicaid, contact your local Medicaid office. Your local Medicaid office's contact information can be obtained by visiting Benefits.gov.