Medicare will Cover my Home Care Services, Right?

Medicare Will Cover My In Home Care Services, Right?

Many people think Medicare will pay for all their medical expenses as seniors including in home care services, nursing home care and medical bills. While Medicare is a wonderful benefit that pays for some medical care, it does not cover everything.

Most people are able to enroll in Medicare Part A coverage at the age of 65 for free, as long as they are eligible for social security benefits. Medicare A covers services that are medically necessary to treat a disease or condition. Examples of medically necessary services include: lab tests, surgeries, doctor visits, wheelchairs and walkers. For hospital care, skilled nursing facility care, nursing home care, hospice and in home care services, certain criteria must be met in order for Medicare to pay.

What does Medicare cover?

For example, Medicare will help pay for skilled nursing home services for rehabilitation for up to 100 days. In order to qualify for this stay, you must have had a hospitalization lasting 3 nights and orders from a physician for rehabilitation services. Medicare covers 100% of rehabilitation fees for the first 20 days of care. After 20 days, Medicare only pays for a portion of the services as long as eligibility criteria is met, but you pay $161 per day. After the 100th day of skilled nursing home services you pay for all nursing home costs.

Does Medicare Cover In Home Care?

In home health care services are provided under Medicare for services related to a skilled need such as skilled nursing care, and physical, speech and occupational therapy. A doctor must order therapy services and you must be considered homebound. Sadly, Medicare will not pay for 24-hour care, meal delivery, homemaker services or personal care services even though these types of services are often required for seniors to stay in their own home. But many times receiving supportive services in your home is less expensive than assisted living or nursing home care.

What about Medicare Part B, Part D and Medigap?

You can choose to enroll in additional Medicare coverage through Medicare Part B, Part D and Medigap. Medicare Part B covers services or supplies that are needed to diagnose or treat your medical condition as well as preventive services. If you want prescription drug coverage, you must pay for Medicare Part D. If you want insurance that will cover some of the gaps in Medicare part A, B, and D you can purchase a private Medicare Gap policy (Medigap) which covers co-payments, coinsurance, and deductibles. Medigap does not cover long-term care, vision, dental, hearing aids, eyeglasses, or in home services.

Medicare covers many medical expenses, but there are a lot of services that you will need to pay for out-of-pocket. Start thinking about your vision of retirement and how you are going to pay for services like in home care early so you can live out that vision.

To learn more about what Medicare will cover visit or consult with the Senior Health Information and Insurance Education (SHINE)