Medicare home health care covers skilled services for homebound beneficiaries who need part-time or intermittent care. To qualify, you must be confined to your home, meaning leaving requires considerable effort or assistance. Your doctor must certify that you need skilled nursing care, physical therapy, occupational therapy, or speech therapy, and must establish a care plan that’s reviewed every 60 days.
Medicare pays for these services when provided by a Medicare-certified home health agency. Covered services include skilled nursing care, physical and occupational therapy, speech-language pathology, medical social services, and home health aide services when paired with skilled care. Telehealth services like remote monitoring and virtual visits are also included. Medical supplies and durable medical equipment prescribed by your doctor are covered as well.
Medicare uses a prospective payment system, paying agencies a predetermined rate for 60-day episodes of care. This covers all necessary services during that period. Beneficiaries pay nothing for covered home health services, though you’ll pay 20% of the Medicare-approved amount for durable medical equipment.