Does Medicare or Medicaid Pay for In-Home Health Care?

There often comes a time in an older American’s life when he or she needs some degree of assistance and support, but does need to permanently reside in an assisted living facility or a skilled nursing facility. For instance, home health care is a common option that is sufficient for an older person’s needs, whether on a temporary or permanent basis. Paying for home health care can be expensive, however, so it is important to know what sort of programs might finance this level of care.

For individuals over the age of 65, Medicare is an option that will pay for some aspects of home health care. Medicare Part A (hospital insurance) and/or Medicare Part B (medical insurance) will cover eligible home health care expenses, such as periodic nursing care, physical or speech therapy, and some occupational therapy services. Typically, a home health care agency coordinates your in-home services pursuant to a plan of care established and reviewed by a doctor.

In order to have Medicare pay for in-home services, however, a doctor must certify that you need the services and that you are homebound, and the home health care agency must be Medicare-certified. In order to have Medicare pay for therapy, the services must be safe, specific, and effective for your medical condition. The amount, frequency, and duration of the services must be reasonable in nature, and they must be sufficiently complex that only qualified therapists can perform them safely and effectively. Additionally, the doctor must expect your condition to improve in a reasonably predictable manner, or you need a skilled therapist to either safely or effectively make a maintenance program for your condition or safely and effectively do maintenance therapy for your condition.

Nonetheless, Medicare will not pay for some aspects of home health care. Non-covered home health care services include 24-hour care in your home, meals delivered to your home, homemaker services (cleaning and cooking), and personal care (assistance with dressing and bathing).

While probate is often necessary, there are measures that you can take prospectively in order to protect and preserve your assets for generations to come. Due to the complexities of these issues, you need an attorney who can provide you the help necessary to get through it. At Legacy Law Center, our Ann Arbor elder law attorneys can help you through any situations that may arise as you work through the estate planning process.