Home health aides are trained specially to assist with your care needs in the safety and comfort of your home. Medicare will pay for limited home health aide services if you meet eligibility requirements for home health care and receive your care from a Medicare-certified home health care agency. Show Learn about Medicare’s stipulations and benefits for home health care coverage, including home health aide services. Does Medicare Cover Home Health Aides?Medicare covers home health aides as part of a physician-ordered plan of care for you in your home if the following requirements are met:
Who Qualifies for Home Health Services Through Medicare?You qualify for home health services through Medicare if your medical condition warrants it and you don’t need more than intermittent care. For instance, you may receive home health care after being treated and discharged from the hospital for an illness or injury until you are more self-sufficient. To be eligible for home health services through Medicare:
What Kinds of Home Health Services Does Medicare Cover?Home health services are provided in your home versus in a hospital or skilled nursing facility. Home health care is less expensive and more convenient for you because it is provided in the comfort of your home. The goals of home health services are to:
The kinds of Medicare-covered home health services you may receive include:
Here are the kinds of home health aide services you may receive ― all must be documented in your individualized plan of care and supervised by a skilled professional:
What Kind of Medicare Coverage Is Best if You Need Home Health Aides?Home health aide services are covered under Medicare Part A, as long as you qualify for home health services and require the services of another skilled professional. Your copay for home health aide services provided within the limits set by Medicare is $0. You can receive your services from any Medicare-approved home health agency. If you have a Medicare Advantage Plan instead of Original Medicare, your requirements and coverage for home health aide services are the same. Home health aide services are a Medicare-covered service under Part A, so Medicare Advantage Plans must offer the same coverage as Original Medicare. Your Medicare Advantage Plan may require you to receive home health care services from an in-network home health agency, and a copay or coinsurance may apply, depending on your plan. If you receive your Medicare benefits through a Medicare health plan (not Original Medicare), contact your plan to find out how it provides your Medicare-covered home health benefits. What Home Health Aides Are Not Covered by Medicare?Home health aides are also called nurse aides or certified nurse aides who have completed federal- and state-mandated training and maintain a license or certification through their state. Medicare will cover licensed or certified aides when their services are part of a plan of care provided by a Medicare-approved home health agency. Medicare will not cover home health aides who do not meet the above requirements or home health aide services that aren’t reasonable and necessary. Additionally, Medicare won’t cover home health aide services that exceed the daily or weekly limit outlined on the plan of care. Sometimes, people refer to personal care providers, personal companions, or homemakers as “home health aides.” Even though their services are valuable and necessary for many seniors, Medicare will not pay for them. Homemaker services such as shopping, cleaning, and laundry are not covered, even if the individual providing them is a licensed or certified home health aide. Medicare also won’t cover custodial or personal care like bathing, grooming, and assistance using the bathroom if this is the only care you need. Kelly Blackwell Certified Senior Advisor (CSA)® As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors. Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice. A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans. As a CSA®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions. |