When a loved one with a disability is ready to transition from a Missouri or Illinois hospital back to their home, the social worker or discharge planner may refer them to a home health provider. If you haven’t utilized the services of an agency before, you might not be familiar with the Medicare home health care benefit. This quick overview should help you better understand what Medicare requires and what services can be provided at home.
Medicare Home Health Care Eligibility
If your loved one receives Medicare because of their age or their disability, it will cover home health services for them if they meet the following criteria:
- They must be under the supervision of a physician who is overseeing the plan of care for their home health services.
- Their physician must certify that they need at least one of the following: intermittent skilled nursing care, physical therapy, speech-language pathology services or continued occupational therapy.
- The home health agency must be Medicare-certified.
- Your loved one must be homebound and their physician must certify to it. Medicare considers patients to be homebound if their condition prohibits them from leaving the house, if it requires a considerable and taxing effort to leave or if they cannot leave home without assistance.
Medicare Home Health Services
Once your loved one meets the eligibility requirements, they can receive care and support services ranging from skilled nursing to speech therapy in the privacy of their own home. Services can include:
- Skilled nursing care for injections, education on how to self-inject, catheter changes, feeding tube care, wound care and more.
- Physical therapy services to help with gait recovery, movement and strength training.
- Speech therapy to regain and strengthen language skills.
- If you are receiving skilled nursing care, physical or speech therapy at home, Medicare will also cover occupational therapy. These services help build skills needed for the activities of daily living, such as dressing, bathing, cooking and eating.
- Medicare will also pay for some medical supplies and durable medical equipment.
- Medical social services such as counseling may also be covered.