2022 Medicare Plans Are Changing
Make sure your plan still has all of your needs covered and learn about new benefits.
Let's face it. For most of us, nothing beats the comfort of our home. Luckily, there are plenty of options for professional in-home care, so you can continue to live at home as you age and enter new stages of life. You might receive temporary home care while recovering from a surgery or hospitalization. Or you may need ongoing home care when aging in place or living with a disability or chronic illness.
No matter your reason for needing home care, it can be downright expensive. If you have Medicare or Medicaid, you might wonder whether home care services are covered. Here's everything you need to know about home care coverage.
Medicare Part A and/or B (Original Medicare) covers some home care expenses.1 These include licensed medical care services such as:
Original Medicare does not cover:
If you have Medicare Part C (Medicare Advantage) or a supplemental plan, check directly with your plan provider for information.
For Medicare to pay for home care, you must meet certain eligibility requirements. These include:
More Tips from the Pros: Read through this year's complete guide to enrolling in Medicare. Our experts break down everything you need to know to get started with Medicare.
For the home health services they cover, Medicare coverage is quite complete. You will pay nothing out of pocket for covered home health care services.
However, you may require durable medical equipment as part of your care. This includes, but is not limited to, such items as:
Under Original Medicare, you will pay 20 percent of the full cost for any durable medical equipment you need. If you have Medicare Advantage or a Medigap plan, contact your plan providers for details.
Pro Tip: Deciding between assisted living or home care? Our experts have taken a deep dive into the difference between assisted living and home care so you can decide what is best for you or your loved one.
Your doctor most likely works with Medicare-certified home health agencies regularly, so he or she may be able to make a recommendation. Alternatively, you can search Medicare's website for certified agencies near you, along with their quality and patient survey ratings. Ask plenty of questions to ensure the agency provides the type of care you need and that you feel comfortable with those who will care for you.
Medicaid is a bit less black and white than Medicare because it is administered by the states. Therefore, the state you live in determines which home care services are covered and what eligibility requirements you must meet. In general, you can expect that if you qualify for Medicaid in your state, some level of home care will be covered.
Did You Know: In some states, family members can be paid by Medicaid for providing personal care to their aging loved one.2
To find out whether you are eligible for Medicaid home care and which services are available to you, find your state's Medicaid profile on Medicaid's Home & Community Based Services page. Then, contact your state's Medicaid department directly.
Your state's Medicaid program is the best place to find home health agencies near you that accept Medicaid. Your doctor may also be able to provide a list of agencies with whom he or she has worked in the past.
Besides Medicare and Medicaid, there are several programs and government aid options to help cover the costs of home care. Each has its own eligibility requirements and list of services it will cover. In addition, paying out of pocket is always an option, though many people will quickly find this cost-prohibitive without a plan to raise enough cash.
Quick Tip: To learn more about the costs of in-home care, visit our home care cost guide.
Scott founded Select Home Care Portland in 2009 and has been helping seniors live their best life at home or in their local senior community ever since. As an advocate for seniors, the primary philosophy has been to listen, educate and provide… Learn More About Scott Witt
Since graduating from Harvard with an honors degree in Statistics, Jeff has been creating content in print, online, and on television. Much of his work has been dedicated to informing seniors on how to live better lives. As Editor-in-Chief of the personal… Learn More About Jeff Hoyt
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