Part A covers inpatient hospitalizations, care in skilled nursing facilities, palliative care, and some home health care. Medicare Part B benefits help pay for home health services, including caregivers. However, it doesn't cover 24-hour care, meal delivery, or personal attention when personal attention is all that's needed. Medicare may cover home health care services for beneficiaries who need assistance caring for others, especially those who can't leave their home because of health problems. Medigap plans, offered by organizations such as AARP, help cover excess costs or “gaps” not covered by Original Medicare, such as copays, coinsurance and deductibles.
However, Medicare does pay for home health care services, such as physical therapy, occupational therapy, speech therapy, skilled nursing care, and social services if you can't leave home after a surgical procedure, illness, or injury. If you want to search for certified agencies in your area, Medicare has a tool that will help you find a home health agency. At age 65, consider taking important steps related to Medicare, health screenings, Social Security, taxes and legal issues. To locate a caregiver in their community, beneficiaries can use the Medicare or U provider search tool.
Based on this demonstration, their home health agency can submit to Medicare a request for a pre-claim review of coverage for home health services. This usually includes short-term stays in a Medicare-approved organization, such as a hospital or skilled nursing facility. Medicare coverage for caregivers varies depending on the type of care needed, how often care is needed, and where care is provided. Medicare Part A will help cover services such as general health care, room costs, meal costs and the cost of the DME.
Medicare will review the information and cover services if the services are medically necessary and meet Medicare requirements. This helps you and the home health agency to know early in the process if Medicare is likely to cover services. Medicare Part A, known as Original Medicare hospital coverage, will cover home health services for 100 days, as long as the beneficiary receives home health care within 14 days of leaving the hospital or nursing facility. When looking for a caregiver, it's possible to narrow down the search based on the fee one is willing to pay for care. However, Medicare doesn't cover long-term custody care, such as those found in memory care or assisted living communities.
It can be difficult to obtain Medicare coverage for full-time care or for facilities such as nursing homes. If a beneficiary needs to be hospitalized for their condition, it's important to understand what Medicare covers so that you can be prepared to explain it to the beneficiary.
