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Medicare Coverage of Home Health Care

Medicare pays for some home health care costs of your loved one. The requirements include:

  • He must be homebound.
  • His doctor must approve a treatment plan.
  • He must need skilled nursing care, but not all the time.
  • He doesn't need attention more than 35 hours a week or 8 hours a day.

What Is Medicaid?

Medicaid is joint federal-state health insurance that pays some medical costs for Americans with low incomes.

Coverage differs from state to state. For guidelines, contact your state's Department of Human Services.

Usually, the benefits include:

Transportation. Ambulance rides to and from the hospital. They can be emergencies or simply needed to keep your loved one's condition stable. Medicaid may also cover trips to and from a clinic or doctor's office.

Ambulatory centers. These are facilities that are run by private companies and public agencies that are not part of a hospital. They offer preventive care, therapy, and rehab under the direction of a doctor.

Ambulatory services covered by Medicaid include dentists, pharmacists, and eye doctors.

Hospital services. These include stays of up to 60 days. Private rooms are covered only when he's got an illness that requires him to be kept away from other patients.

He's covered for "outpatient care," which means he doesn't need an overnight hospital stay.

Labs and image tests such as X-rays and MRIs are also covered.

Medical supplies and medications. These are covered when prescribed by his doctor, dentist, or podiatrist (foot doctor). Some medical equipment, such as hospital beds, wheelchairs, side rails, and oxygen tanks, is also covered.

Home health care. He's covered for visits by a nurse, home health aide, or physical therapist.

Skilled nursing homes. These and intermediate-care facilities (which provide short-term treatment for a patient whose condition is stable or reversible) are covered with a doctor's consent.