There are many reasons why someone might require assistance in their daily life at home. This could be due to aging, recovery from illness or injury, a chronic condition, disability, or mental health issues. At home care has many benefits over a residential facility or nursing home, but it does cost money–even in the case of people who have family members to take care of them. With that in mind, you might be wondering about the cost of home care, or asking yourself: “How do I get home care through Medicare?”
The answer is that, while it is possible to get home care through Medicare, there are strict conditions that must be met for this, and these can vary from state to state. However, there are also affordable or government assisted alternatives for home care in Indiana that may work better for you. In this article, we’ll look at how to get home care through Medicare and what other options are available.
How To Get Home Care Through Medicare
Medicare’s home health benefit covers certain services such as therapy or care by a visiting nurse or home health aide. Depending on your situation, this could be covered by either Part A (hospital insurance) or Part B (medical insurance). Usually, home care is covered under Medicare Part B, but Part A may apply if you have just left a hospital or skilled nursing facility (SNF). In either case, you could get Medicare to cover your home health care if you are both:
- Homebound, i.e., unable to leave your home without help, or leaving your home is not medically recommended
- In need of intermittent skilled nursing or therapy services on a regular and finite basis.
In the latter case, intermittent care sessions could mean anything from once every two months up to once a day. The standard period for this is three weeks, which can be extended if you need further care or have a chronic condition, but the intention is that it is for a finite, predictable period. Skilled care, according to Medicare, means care that must be performed by or under the supervision of a skilled professional, e.g., a nurse, or therapist in the case of physical, speech, and occupational therapy.
To receive home care through Medicare, it must be from a Medicare-certified home health agency (HHA). To apply for home health care through Medicare, the HHA needs to visit you, assess your needs, and create a care plan for you. This can be arranged by asking your doctor for a list of HHAs and contacting them directly. If you are in the hospital, ask the discharge planner or a hospital social worker to contact the HHA.
Applicants for home health care via Medicare then need to have a face-to-face meeting with a doctor up to 90 days before or 30 days after they start 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 in need of intermittent skilled care.
What Type Of Home Care Is Not Covered By Medicare In Indiana?
Medicare’s home health benefit does not cover all home care services. Services excluded from Medicare coverage include:
- 24-hour daily care
- Prescription drugs
- Meals delivery
- Homemaking services, e.g., housekeeping, meal prep, or laundry
More details on what is and is not covered by Medicare can be found here. Generally speaking, Medicare can help with home care that is strictly medically necessary and requires medical professionals to carry out.
Should I Choose A Home Care Agency?
After reading the above, you might be thinking that you or your loved one may not qualify for or necessarily need the type of home care covered by Medicare, especially if skilling nursing or therapy is not required in the home. For example, you may be looking for more frequent care visits, 24-hour care, assistance with transport, or a program that includes meal preparation and housework.
In this case, a private home care agency such as Nova Home Care may be the better option for you or your loved one. Going with a private home care agency means keeping complete control over the care services provided and being able to choose a care plan and schedule that works best for you.
Nova Home Care provides professional, personalized in-home care services in all of the Indiana counties. Our services are covered by Medicaid, and we can help you organize a comprehensive care plan for yourself or a loved one that also incorporates any government support you may be entitled to.
Contact us online or call 317-537-2490 to find out more about how we can help you or a family member live a fulfilling and comfortable life at home.