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Medicare Will Pay for these Types of Home Care

February 7, 2017

What You Get, If You Qualify! senior cheering in chair

Here are Home Services BrightStar Care Evanston Can Provide Covered by Medicare

Maybe this photo raises the praise a bit high, but it will be surprising and welcome news to many that Medicare will cover in-home services if  you qualify for the home health benefit.  What does qualifying take? Good news, it's not easy but not impossible. Check out the requirements here and tell the U.S. Government, BrightStar Care Evanston sent you. Here's what you get if you meet the standards:
  • Skilled nursing services and home health services:  Provided up to seven days a week for no more than eight hours per day and 28 hours per week (Medicare can cover up to 35 hours in unusual cases).
  • Skilled nursing care: (Slightly different and more specific than nursing services discussed above), this includes services and care that can only be performed safely and effectively by a licensed nurse. Medicare may cover:  performing injections (and teaching patients to self-inject), tube feedings, catheter changes, observation and assessment of a patient’s condition, management and evaluation of a patient’s care plan, and wound care.
  • Services of a home health aid: This can be wonderful! A home health aide provides personal care services including help with ADL's (Acts of Daily Living): bathing, using the toilet, and dressing. Help with these duties is often needed by seniors and these services are also valued by caregiving families. Here's an important point, however: if you ONLY require personal care, you do NOT qualify for the Medicare home care benefit.
  • Skilled therapy services. You may be covered for physical, speech and occupational therapy services.(Speaking of speech qualifications), coverage is possible if speech services can only be performed safely by or under the supervision of a licensed therapist. Care must also be "reasonable and necessary for treating your illness or injury." Physical therapy includes gait training and supervision of and training for exercises to regain movement and strength to a body area. Speech-language pathology services include exercises to regain and strengthen speech and language skills.

     

    Occupational therapy* helps you regain the ability to do usual daily activities by yourself, such as eating and putting on clothes.Medicare should pay for therapy services to maintain your condition and prevent you from getting worse as long as these services require the skill or supervision of a licensed therapist, regardless of your potential to improve. (That's good news.)
  • Medical social services. Medicare pays in full for services ordered by your doctor to help you with social and emotional concerns you have related to your illness. This might include counseling or help finding emotional support resources in your community.
  • Medical supplies. Medicare pays in full for certain medical supplies provided by the Medicare-certified home health agency, such as wound dressings and catheters needed for your care.
  • Durable medical equipment. Medicare pays 80% of its approved amount for certain pieces of medical equipment, such as a wheelchair or walker. You pay 20% coinsurance (plus up to 15% more if your home health agency does not accept “assignment.)
*If you only need occupational therapy, you will not qualify for the Medicare home health benefit. However, if you qualify for Medicare coverage of home health care on another basis, you can also get occupational therapy. When your other needs for Medicare home health end, you should still be able to get occupational therapy under the Medicare home health benefit if you still need it. Those are the government rules and they're sticking to them. For more information, visit the government site on Medicare and Home Care Services at Medicare.gov and please tell them BrightStar Care Evanston sent you. For more information on our skilled and compassionate services available when and where you need them, for a few hours a day or 24, please Contact us online or call (847) 510-5750 today to find out how we can help you and your loved ones. And don't forget our offer for a FREE in home consultation regarding your personal needs.