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    Medicare Coverage of Home Care

    In order to receive home care under Medicare:

    • You must be home-bound.
    • Your doctor must certify a plan of care.
    • Care must be needed on an intermittent (not continuous) basis.
    • Care cannot exceed 35-hours per week or eight hours per day.
    • Physical or speech therapy must be provided on a "necessary and reasonable" basis. There are no restrictions on the number of days or hours per week of these therapies.
    • If you qualify for home health care, you are entitled to a home health aide to provide some personal care.

    What Is Medicaid?

    Medicaid is a joint federal-state health insurance program providing medical assistance primarily to low-income Americans. It also is available to people under 65 if they are blind or disabled.

    The purpose of Medicaid is to provide preventive, therapeutic, and remedial health services and supplies that are essential to attain an optimum level of well-being.

    How Do People Receive Medicaid Benefits?

    Medicaid eligibility requirements depend on financial need, low income, and low assets. In determining Medicaid eligibility, officials do not review rent, car payments, or food costs. They only review medical expenses. Medical expenses include:

    • Care from hospitals, doctors, clinics, nurses, dentists, podiatrists, and chiropractors
    • Medications
    • Medical supplies and equipment
    • Health insurance premiums
    • Transportation to get medical care

    The four eligibility tests required to receive Medicaid include:

    • Categorical. You must be age 65, blind, or disabled.
    • Non-Financial. You must be a U.S. citizen and a state resident. You also must have a social security number.
    • Financial. Your total gross income, personal assets, and property will be evaluated and must meet a certain standard. This amount varies from state to state.
    • Procedural. You must complete and sign an application and have a personal interview with a Medicaid official.

    Each eligible Medicaid recipient receives a monthly medical identification card. The card is valid for one month only.

    Medicaid Coverage

    Medicaid coverage varies from state to state. For specific coverage guidelines, contact your state's Department of Human Services. Generally, Medicaid benefits include:

    Transportation

    • Ambulance services when other means of transportation are detrimental to the patient's health
    • Transportation to and from the hospital at time of admission or discharge when required by the patient's condition
    • Transportation to and from a hospital, outpatient clinic, doctor's office or other facility when the doctor certifies the need for this service
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