Does Medicare Cover Home Care In Arizona?

October 18, 2023

Home care becomes a necessity for many Americans in their daily lives, whether that be due to aging, illness, disability, or recovery from injury. In these cases, in-home assistance is provided by caregivers who may either visit or reside with the individual in need. Sometimes, the caregiver is a medical professional, such as an occupational therapist or nurse. In other cases, the primary aim of home care is to aid with routine daily tasks like bathing, grooming, meals, or household chores like laundry and housekeeping. These types of non-medical home care services are usually not covered by Medicare but are often administered by home care agencies.

The question of whether Medicare or Medicaid covers home care services can be difficult to understand, especially since the rules governing home care vary from state to state. In this article, we will examine whether Medicare can cover home care in Arizona.

Does Medicare Pay For Home Care In Arizona?

Home care is linked to an improved quality of life and better health outcomes compared to residing in a nursing home. The advantages of allowing patients to maintain their independence in a familiar environment close to their family and friends should not be underestimated.

However, home care comes with associated costs, either in the form of payments to professional in-home caregivers or spending one’s own resources to care for relatives, a situation that over 38 million Americans find themselves in. This raises the question of whether Medicare can be utilized to cover home care expenses in Arizona.

The answer to this question depends on your particular situation. While Medicare in Arizona can cover home care, it only does so under specific circumstances. Nevertheless, it’s important to note that Medicare is not the only way to obtain financial assistance with home care. There are cost-effective home care agencies in Arizona whose services are covered by Medicaid, and they can provide a broader spectrum of services compared to what Medicare offers.

Medicare For Home Care In Arizona

Medicare’s home health benefit extends to certain medical services provided in the home, but only if two essential criteria are met.

First, the in-home services must necessitate skilled medical care. This refers to health services that require the expertise of a trained medical professional, such as:

  • Intermittent skilled nursing care (Medicare does not cover 24/7 home care)
  • Physical therapy
  • Speech therapy
  • Occupational therapy
  • Services requiring durable medical equipment or supplies

The other condition is that the care recipient be homebound. This means:

  • You are unable to leave the house without assistance 
  • You require a wheelchair, walker, or other specialized transportation due to illness or injury
  • Your doctor has advised against leaving your home

If you meet these conditions, Medicare Part A (hospital insurance) can cover home care if you’ve recently been discharged from a hospital or facility. Otherwise, home care through Medicare may be covered under Part B (medical insurance).

How To Get Medicare To Pay For Home Care In Arizona

Medicare only covers home care if it is administered by a Medicare-certified home health agency (HHA). If you meet the aforementioned conditions, the application process begins by requesting a list of HHAs from your doctor and contacting them. If you are still in the hospital, you can ask the relevant hospital staff, such as a discharge planner, to coordinate post-discharge home care with the HHA.

The HHA will arrange a visit to evaluate your needs and formulate a care plan. This plan must then be approved by your doctor, either within 90 days before or 30 days after the commencement of the home care period.

Does Medicare Cover 24/7 Home Care?

Medicare’s home health benefit explicitly excludes coverage for cases requiring 24-hour daily care. Additionally, Medicare does not cover other services such as prescription medications, meal delivery, or homemaking services like housekeeping, laundry, or meal preparation. More information on what precisely is covered by Medicare can be found here.

If you or your loved one is in need of 24/7 care or non-medical care services, it may be better to arrange care through a home care agency.

Home Care Agency With Medicaid In Arizona

Nova Home Care is a home care agency that offers professional, personalized in-home care services in Arizona. Our services are covered by Medicaid, and we can help you construct a care plan for yourself or a loved one that includes any government benefits to which you may be entitled.

For those caring for a family member and seeking support, we also offer opportunities to become a caregiver and receive compensation, training, resources, and employment benefits for looking after a relative in need.

By choosing Nova Home Care Arizona, you can access services beyond what Medicare covers, including personal care (such as grooming, meals, hygiene, and assistance with daily activities), transportation to and from appointments and errands, as well as companionship and mental stimulation.To learn more about how we can assist you or a family member, you can contact us online or call us at 317-537-2490.

You May Be Eligible!