Medicare covers home care through its home health benefit if you meet the eligibility requirements. You must 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. to qualify for Medicare’s home health benefit. If you are eligible, Medicare may also cover other services, such as personal care Personal care, also known as unskilled care, is assistance with activities of daily living. Providers of personal care (home health aides) are not required to undergo medical training. Medicare only covers personal care if you are homebound and receiving skilled care. .
Remember: If you need home health care Home health care is care provided at home to treat an illness or injury. Medicare will only cover home health care if you are homebound and have a need for skilled care, including skilled nursing and/or skilled therapy services. and/or personal care services but do not need skilled care, Medicare will not pay for your care. If you are not eligible for Medicare-covered home care, you may want to consider other options, such as the following:
- Medicaid is a state and federal program that provides health coverage if you have a limited income. Medicaid Medicaid is a federal and state program that provides health coverage for certain people with limited income and assets. benefits coordinate with Medicare.
- Program for All-Inclusive Care for the Elderly (PACE) is a state-sponsored home care program.
- Home care organizations in your area may provide services at low or reduced costs.
- Alternative living arrangements may help you access needed care. For instance, you could move in with someone you know and provide them with rent assistance in exchange for help with personal care needs.
- Medicare’s hospice program provides certain home care services. You are eligible for hospice Hospice is a program of end-of-life pain management and comfort care for those with a terminal illness. Medicare’s hospice benefit includes inpatient care and outpatient care, respite care, prescription drugs, counseling, and social services. if you are terminally ill.
You can also contact your State Health Insurance Assistance Program (SHIP) for assistance and counseling. You may want to consider speaking to a home health agency to learn more about costs if you must pay out of pocket.