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Will Medicare Pay for My Loved One’s In Home Care?

By , 8:20 am on
Paying for in home care with medicare

What can you do when your loved one gets out of the hospital but needs more help than you are qualified or able to give? Will Medicare pay for in home care? The answer is maybe.

When a loved one is sick or recovering from a serious illness or surgery, he or she might need skilled nursing care, specialized therapy, or medical equipment. Medicare may pay for rehabilitation at home instead of in a nursing facility, but Medicare won’t help with every type of in home care nor in every instance that it’s needed.

In Home Care:  Medical vs. Non-medical

If your loved one needs in home care, you’ll need to know the difference between medical and non-medical care before asking for Medicare coverage. This is typically the determination of whether your loved one will have coverage or not.

Medical care: When your loved one’s doctor makes a request for specific medical care and the patient has opted for home health benefits, it’s likely that there will be coverage for skilled nursing or medical care in the home, such as physical rehab, administration of medicines, or medical-social services. Some medical equipment may be provided, as well.

Non-medical care: If your loved one’s doctor determines that only non-medical care is needed, Medicare won’t pay for it. They don’t cover help with hygiene, dressing, exercise, meal prep, light housekeeping, running errands, transportation, buddy calls, or safety checks. These services may be necessary, yet they’re usually not covered by Medicare.

The Question: Will Medicare Cover in Home Care?

Maybe. Medicare covers some services and sometimes all of your in home care if specific conditions are met:

  1. The doctor accepts Medicare assignment.
  2. The patient is certified to be homebound and special medical equipment is needed before the person can leave home.
  3. The doctor orders in home care, specifically stating that there’s need for intermittent skilled in home care.
  4. The doctor has attended to the patient in person to confirm that medical in home care is necessary.

To sum it up, in home care may be paid by Medicare, but only if skilled nursing or medical services are required – not for personal or non-medical care.

How Home Care Assistance of Nashville Can Help

Home Care Assistance of Nashville 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.