I’m in the hospital after surgery and am getting ready to go home. I think it will be difficult to get around or leave my house for appointments and physical therapy, though. Will Medicare cover physical therapy in my home?
-Wallace (Buffalo, WY)
Yes, Medicare covers home health care, if you qualify. Medicare can cover the following home health services:
- Skilled nursing services, such as injections, tube feedings, catheter changes, observation and assessment of your condition, and wound care
- Provided up to seven days per week for generally no more than eight hours per day and 28 hours per week.
- Skilled therapy services, such as physical therapy, speech language pathology, and occupational therapy
- Home health aide, who provides personal care services like bathing, toileting, and dressing
- Note: Medicare pays in full for an aide if you require skilled care. Medicare will not pay for an aide if you only require personal care and do not need skilled care.
- Medical social services, such as counseling or help finding resources in your community. Medical social services are ordered by your doctor to help with social and emotional concerns you have related to your illness.
- Medical supplies, such as wound dressings and catheters
- Durable medical equipment (DME), such as wheelchairs and walkers
There are certain requirements you must meet to be eligible for the home health benefit. For example, you must be considered homebound and have a plan of care approved by your doctor. It is also important to know that your home health care is covered by Medicare even if your condition is chronic or if you are not showing signs of improvement.
Speak with your doctor or hospital discharge planner to begin home health care. If you need home health care, it should be included as part of your hospital discharge plan. If you have Original Medicare, call 1-800-MEDICARE or visit www.medicare.gov/care-compare to find a list of Medicare-certified home health agencies (HHAs). If you have a Medicare Advantage Plan, you should contact the plan directly for a list of HHAs in your plan’s network.