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Medicare home health coverage can mean the difference between an individual staying home or becoming a nursing home resident.  While the Medicare skilled nursing facility benefit is very limited, for beneficiaries who meet the coverage criteria, the home care benefit can be an ongoing Godsend.

For people who can’t readily leave home without a major effort and/or assistance (defined as “homebound”), and who need nursing, physical, speech, or occupational therapy, Medicare home health coverage may be available. If so, Medicare covers these services as well as home health aides to assist with the activities of daily living – such as eating, dressing, bathing, and toileting.  Social worker services and medical supplies are also coverable.

It is a common misunderstanding that Medicare home care coverage is “an acute care benefit only.” CMS and Medicare policy-makers often repeat this refrain. But it’s not true. In fact, according to federal regulations and CMS policy, the home health benefit has no duration of time limitation.  Indeed, in 1980 Congress actually rescinded the 100-visit limitation and removed a prior hospital requirement. Further, there is no co-insurance – although proposals appear annually to impose one. 

Medicare helps people receive necessary care at home. To learn more about this important benefit, go to https://www.medicareadvocacy.org/medicare-info/home-health-care/.

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