Whether due to aging, illness, or recovery from injury, many Americans can end up requiring some help around the house in daily life. Home care refers to when a caregiver, someone who visits or lives with the recipient, helps take care of them. Sometimes, these services are explicitly medical in nature, e.g., if occupational therapy or nursing services are provided. In other cases, all that is needed from home care services is assistance in normal daily tasks such as bathing, grooming, and eating, or domestic chores like laundry and housekeeping. These types of non-medical care are usually handled by a home care agency.
It may be that a mix of medical and non-medical services is required. Because of this, there is often confusion as to whether Medicare or Medicaid covers home care. The rules governing home care vary from state to state, but in this article, we will look specifically at the state of Indiana.
Does Medicare Pay for Home Care in Indiana?
Home care is associated with a higher quality of life and better health outcomes compared to a nursing home. One shouldn’t underestimate the benefits of allowing the patient to maintain their independence while staying in a familiar environment, close to their family and friends.
However, home care costs money: either because you pay a professional in-home caregiver for their services, or because, as is the case for over 38 million Americans, you end up caring for your loved one yourself, in your own time, and at your own expense. That’s why you might end up asking yourself if you can get Medicare to cover home care in Indiana.
The answer? It depends. Medicare in Indiana can cover home care, but only under certain conditions. However, Medicare is not the only option for assistance with home care. There are affordable home care agencies in Indiana whose services are covered by Medicaid and can offer a wider range of services than what is available through Medicare.
Medicare For Home Care In Indiana
Medicare’s home health benefit covers certain services carried out in the home but only if two requirements are met.
First, the in-home services must require skilled medical care. This means health services that must be carried out by a trained medical professional, such as:
- Intermittent skilled nursing care (24/7 home care is not covered by Medicare)
- Occupational therapy
- Physical therapy
- Speech therapy
- Services using durable medical equipment or supplies
The other condition is that you must be homebound. This means:
- Unable to leave the house without help from someone else
- Need a wheelchair, walker, or other special transportation because of illness or injury
- Your doctor has recommended to not leave your home
If you meet these conditions, then home care can be covered by Medicare Part A (hospital insurance) if you have just left the hospital or facility following injury or illness. Otherwise, home care via Medicare will be covered by Part B (medical insurance).
How To Get Medicare To Pay For Home Care
Medicare only covers home care if it is carried out by a Medicare-certified home health agency (HHA). If you meet the above conditions, the application process starts by asking your doctor for a list of HHAs and contacting them. If you are still in the hospital, ask the relevant hospital staff, such as a discharge planner, to contact the HHA to arrange post-discharge home care.
The HHA will schedule a visit to assess your needs and create a care plan. The plan must then be approved by your doctor, either in 90 days before or 30 days after the start of the home care period.
Does Medicare Cover 24/7 Home Care?
Unfortunately, Medicare’s home health benefit explicitly does not cover cases that need 24-hour daily care. Other services that Medicare will not cover include:
- Prescription medications
- Meals delivery
- Homemaking/housekeeping services such as laundry or meal preparation
Further details on what exactly is covered by Medicare can be found here.
If you or a loved one is in need of 24/7 care or could benefit from non-medical services, it may better to approach a home care agency.
Home Care Agency With Medicaid In Indiana
Nova Home Care is a home care agency that provides professional, personalized in-home care services in the state of Indiana counties. Our services are covered by Medicaid, and we can help you organize a care plan for yourself or a loved one that also includes any government benefits you may be entitled to. If you are caring for a family member and looking for support, apply to be a caregiver and receive salary, training, resources, and employment benefits for taking care of a relative in need.
By choosing Nova Home Care, you can benefit from services beyond what Medicare will cover, such as:
- Personal care–grooming, meals, hygiene and assistance with daily activities
- Transportation to and from appointments and errands
- Companionship and mental stimulation
Contact us online or call 317-537-2490 to find out more about how we can help you or a family member live a safe and satisfying life at home.