Medicare Covers Medically Necessary Care at Home

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Medicare Covers Medically Necessary Care at HomeAbout 70 percent of people turning age 65 can expect to use some form of long-term care during their lives, according to the U.S. Department of Health and Human Services.

SOURCE: www.longtermcare.com

Do you know what Medicare covers?

Medicare covers medically necessary care, such as doctor visits, drugs, and hospital stays. Medicare coverage also includes short-term services for conditions that are expected to improve, such as physical therapy to help you regain your function after a fall or stroke. In addition, Medicare covers a short stay in a skilled nursing facility or for home health care services as long the following conditions are met:

  • You have had a recent prior hospital stay of at least three days.
  • You are admitted to a Medicare-certified nursing facility within 30 days of your prior hospital stay.
  • You need skilled care, such as skilled nursing services, physical therapy, or other types of therapy.

Long-Term Care Services – Home and Other Care Services

In addition to skilled nursing facility services, Medicare pays for the following services for a limited time when your doctor says they are medically necessary to treat an illness or injury:

  • Part-time or intermittent skilled nursing care.
  • Physical therapy, occupational therapy, and speech-language pathology that your doctor orders that a Medicare-certified home health agency provides for a limited number of days only.
  • Medical social services to help cope with the social, psychological, cultural, and medical issues that result from an illness. This may include help accessing services and follow-up care, explaining how to use health care and other resources, and help understanding your disease.
  • Medical supplies and durable medical equipment such as wheelchairs, hospital beds, oxygen, and walkers. For durable medical equipment, you pay 20 percent of the Medicare approved amount.

There is no limit on how long you can receive any of these services as long as they remain medically necessary and your doctor reorders them every 60 days.