You can receive home health care coverage under either Medicare Part A or Part B. Under Part B, you are eligible for home health care if you are homebound Medicare considers you homebound if: you need the help of another person or medical equipment (such as a walker or wheelchair) to leave your home, or your doctor believes that your health could get worse if you leave your home; and it is difficult for you to leave your home and you typically cannot do so. A doctor must evaluate and certify this condition. Leaving your home for medical treatment, religious services, and special non-medical events such as a family reunion or funeral does not mean that you are not homebound. and need skilled care Skilled care is medically necessary care that must be performed by a skilled professional, or under their supervision. Skilled nursing includes care from registered nurses and licensed practical nurses. Skilled therapy includes care from licensed physical, occupational, and speech therapists. . There is no prior hospital stay requirement for Part B coverage of home health care. There is also no deductible The deductible is the amount you must pay for health care expenses before your health insurance begins to pay. Deductible amounts can change every year. or coinsurance The coinsurance is the portion of the cost of care you are required to pay after your health insurance pays. Usually, it is a percentage of the approved amount or negotiated amount. In Original Medicare, the coinsurance is usually 20% of Medicare’s assignment. for Part B-covered home health care.
While home health care is normally covered by Part B, Part A provides coverage in certain circumstances after you are in a hospital or skilled nursing facility (SNF). Specifically, if you spend at least three consecutive days as a hospital inpatient An inpatient is a patient who has been formally admitted into the hospital by a doctor. Most inpatient care is covered under Medicare Part A (hospital insurance). or have a Medicare-covered SNF stay, Part A covers your first 100 days of home health care. You still must meet other home health care eligibility requirements, such as being homebound and needing skilled care. You also must receive home health services within 14 days of your hospital or SNF discharge Discharge is the end to your stay as an inpatient in a medical institution such as a hospital or skilled nursing facility (SNF). to be covered under Part A. Any additional days past 100 are covered by Part B. Regardless of whether your care is covered by Part A or Part B, Medicare pays the full cost.