Does Medicare Cover Home Care?
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Whether you’re planning ahead and considering future care options or you or a loved one are currently struggling with everyday tasks, it’s worth considering home care services. After all, aging in place lets you grow older in the comfort of your own home, so you don’t need to worry about giving up your privacy, moving away from your friends and family, downsizing your possessions or leaving behind your memories. In-home care helps you safely stay in your beloved home with diverse services tailored to meet your specific needs and requirements.
In-home care services are essential for many seniors who want to stay at home, but they can quickly drain your finances and leave you wondering if it’s worth the extra cost, which depends on services, hours and location. On average, in-home and home health care services cost $4,957 and $5,148 per month, respectively, throughout the United States (assuming 44 hours of care per week). It’s important that older adults can access affordable care and support services. This is where Medicare can be a valuable asset.
Home Health Care vs. Home Care
First, let’s explore how home health care and home care services can help you live comfortably at home. If you have medical needs, you’ll likely be interested in the clinical and therapeutic services provided by home health care agencies. For example, if you’ve had surgery, a stroke or a long-term illness, in-home nursing might be just what you need to get you feeling right as rain again. Rehabilitation specialists can provide physical, speech and occupational therapy in the comfort of your own home. Your care team may also assist you in managing chronic conditions such as diabetes and heart disease, as well as ensuring that you take medications as prescribed.
If you don’t need medical care but need help with daily tasks such as bathing, brushing your teeth, using the toilet and getting dressed, a home health care aide may be a better option. For example, if you need help moving around your home or switching from your bed to a chair, home care might help give you back your mobility. Aides can lighten the domestic load, taking care of chores such as your housework and laundry, while you sit back and enjoy your retirement. Someone might make your meals, do your grocery shopping, take you places and simply hang out with you if you’re feeling a bit lonely.
When it comes to paying for care, Medicare doesn’t cover all in-home care services. Whether Medicare pays will depend on the exact services you need.
What Medicare Will and Won’t Cover
First, Medicare won’t cover any in-home services if you aren’t classified as being homebound. This means that you cannot leave your home due to an injury or illness, or leaving your home requires too much effort. If your doctor instructs you not to go out, Medicare usually has you covered.
To qualify for visiting caregivers, your doctor must certify that you require limited medical or therapeutic services on an as-needed basis. Unfortunately, as nice as it would be, Medicare won’t pay for a live-in caregiver.
If you need some skilled nursing or medical social services, Medicare pays for your care. You don’t need to worry about being billed for speech-language, occupational or physical therapies, either. It will also cover the costs of medical supplies to use at home, such as catheters and surgical dressings. Need durable medical equipment, such as mobility aids, oxygen equipment, hospital beds or blood sugar monitors? Medicare covers these expenses as well.
Other Financial Assistance Options
If you don’t qualify for Medicare to help cover the costs of home care, don’t panic; other sources of funding may be available to help you.
If you’re aged 65 or older, blind or disabled, you may qualify for Medicaid funding. Depending on your state, the regular Medicaid program might cover in-home care. In most places, though, you’ll need to apply for programs called home- and community-based services waiver programs. To qualify, you must prove that you have limited funds and would struggle to pay for services out of pocket. Furthermore, you require the services to live alone and would have to move into a nursing home without assistance.
Depending where you live, the Program of All-Inclusive Care (PACE) may help you to pay for home care. This joint Medicare-Medicaid program can help people avoid nursing homes for as long as possible.
If you served in the U.S. Armed Forces, you may qualify for VA benefits or programs that help cover the cost of home care services. It’s worth making an appointment with your local VSO and asking what assistance you can get.
Long-term care insurance plans sometimes pay for non-medical home care services. Although general health insurance policies typically don’t cover such services, it’s always worth checking your policy to be sure. Who knows? You might be pleasantly surprised. You may also be able to use life insurance policies to pay for home care.
Do you own your home? If so, a reverse mortgage might make home care more affordable. This basically frees up some of the equity in your home and gives you cash in your hand.
The Bottom Line
If you need medical or therapeutic services, there’s a strong chance that Medicare will cover the costs of your home health care services. If you only need assistance with day-to-day activities or personal care, Medicare won’t pay for home care services, but you may be able to get help from other resources. It’s important you always seek advice and support when looking into your care options, including funding, to make sure you get all the help you can.
