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Does Medicare Cover Home Health Care & Assisted Living? 

Does Medicare Cover Home Health Care & Assisted Living?  

While Medicare doesn’t cover assisted living facilities, it does cover intermittent skilled nursing care at home. Coverage includes nursing care, therapy, social services and medical supplies. 

You won’t pay anything for the home health care services, but you will be required to pay 20 percent of the Medicare-approved amount if you require medical equipment.  

How to Qualify for Home Health Care

To receive home health care with Medicare, you must meet certain conditions: 

  • You have to be homebound. This means you cannot leave home without a great deal of effort if you can leave home at all.
  • You need to be under a care plan that your doctor developed. Your plan needs to undergo regular reviews from that doctor. That doctor also must state that you need home health care services. These services can be speech pathology, occupational therapy, skilled nursing, or physical therapy.
  • ou must choose a home health agency that is approved by Medicare. If you choose an agency that is not approved by Medicare, you will have to shoulder the costs.

Benefits Provided

Medicare Part B covers home health care and includes part-time skilled nursing care. 

The home nursing care can be for up to eight hours a day and for no more than 21 days. Skilled nursing care includes a variety of services, such as wound dressings and injections.

The coverage also includes occupational, physical, and speech therapy. The therapy addresses the medical condition or conditions mentioned in your treatment plan.

You will also have access to home health aides who will help you to complete tasks such as dressing, going to the restroom and preparing meals. Keep in mind that if you only require help from home health aides, you cannot get home health care coverage – it is intended as an addition to the other care you need.

Medical social services are also covered, including counseling and information about community services.

Finally, you can get medical supplies (for example, catheters) to help with your condition. 

Get Help With Home Health Care

You can also receive home health care with a Medicare Advantage (Medicare Part C) plan. If you are unsure if you want to use Original Medicare or Medicare Advantage, speak to a licensed insurance agent. The agent will help you choose the right coverage for your home health care needs.