How Do I Get Home Care Through Medicare in Colorado?

October 18, 2023

Whether due to aging, recovery from illness or injury, chronic conditions, disabilities, or mental health challenges, many Americans require assistance in daily life at home. In-home care offers many advantages over residential facilities or nursing homes, but it does come with associated costs, even when family members are involved in caregiving. Consequently, you may be looking at the cost of home care and wondering, “How do I get home care through Medicare?”

The reality is that while obtaining home care through Medicare is possible, there are strict requirements that must be satisfied, and these can differ from one state to another. Nevertheless, there are also cost-effective alternatives or government-assisted options for home care in Colorado for you. In this article, we examine the process of obtaining home care through Medicare in Colorado and explore the different choices.

How To Get Home Care Through Medicare in Colorado

Medicare’s home health benefit in Colorado is similar to how it works in other states.  Depending on your circumstances, this coverage can fall under either Part A (hospital insurance) or Part B (medical insurance). Typically, home care is covered by Medicare Part B, although Part A may apply if you’ve recently been discharged from a hospital or skilled nursing facility (SNF). To qualify for Medicare coverage of your home health care, you must meet the following criteria:

  • Homebound, i.e., you cannot leave home without help, or your doctor has recommended that you not leave home. 
  • In need of intermittent skilled medical services on a regular basis for a limited time.

In the latter case, intermittent care could range from once every two months up to once a day, with a standard period being three weeks. This period can be extended if further care is required or if you have a chronic condition. Skilled care, as defined by Medicare, encompasses care provided by or under the supervision of skilled professionals, such as nurses or therapists for physical, speech, and occupational therapy.

To receive home care through Medicare, it must be provided by a Medicare-certified home health agency (HHA). To initiate the process, you should request a list of HHAs from your doctor and then contact them directly. If you’re in the hospital, you can ask the discharge planner or a hospital social worker to facilitate contact with the HHA.

Applicants for home health care via Medicare must also undergo a face-to-face meeting with a doctor within 90 days before or 30 days after commencing home health care. The doctor must approve a health plan for the patient and sign a home health certification, confirming that the patient is homebound and necessitates intermittent skilled care.

What Type Of Home Care Is Not Covered By Medicare In Colorado?

It’s important to recognize that Medicare’s home health benefit doesn’t encompass all home care services. Services excluded from Medicare coverage in Colorado include:

  • 24-hour care 
  • Prescription drugs
  • Food delivery
  • Homemaking, such as housekeeping and laundry services

Additional details regarding what is and isn’t covered by Medicare can be found here. In summary, Medicare assists with home care that is strictly medically necessary and requires the involvement of medical professionals.

Should I Choose A Home Care Agency in Colorado?

If you think that you may not qualify for or necessarily require the very specific types of home care covered by Medicare, there are alternatives. For instance, a home care agency in Colorado can help you secure Medicaid benefits through Health First Colorado and Colorado’s In-Home Support Services (IHSS) to provide more frequent care visits, training as a paid family caregiver, help with transportation, or a program that includes meal preparation and housekeeping.

Opting to go through a private home care agency affords you full control over the provided care services, allowing you to select a personalized care plan and schedule that aligns with your preferences.

Nova Home Care Colorado delivers professional, personalized in-home care services across all Colorado counties. Our services are covered by Medicaid, and we can take care of all the Medicaid paperwork as we collaborate with you to establish a comprehensive care plan that also incorporates any government assistance you may be eligible for.

To discover more about how we can assist you or a family member in leading a fulfilling and comfortable life at home, please contact us online or call 317-537-2490.

You May Be Eligible!