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En español | Home health care services are a valuable Medicare benefit that provides skilled nursing care, therapy and other aid to people who are largely or entirely confined to their homes.
In 2017, Medicare spent $17.7 million on home health services for 3.4 million beneficiaries, more than double the amount expended in 2001, according to the federal Medicare Payment Advisory Commission.
To be covered, the services must be ordered by a doctor, and one of the more than 11,000 home health agencies nationwide that Medicare has certified must provide the care. Under these circumstances, Medicare can pay the full cost of home health care for up to 60 days at a time.
That period is renewable, meaning Medicare will continue to provide coverage if your doctor recertifies at least once every 60 days that the home services remain medically necessary.
To be eligible for Medicare home health benefits, you must meet all of these conditions:
Either element of original Medicare — Part A hospital insurance and/or Part B doctor visits and outpatient treatment — might cover home care. Services include these:
If you need full-time or long-term nursing care, you probably will not qualify for home health benefits.
This might also include durable medical equipment from the home health agency, such as walkers or wheelchairs, but for those Medicare does not pay the full cost. You usually are responsible for 20 percent of the Medicare-approved amount.
Medicare does not cover:
Medicare’s website has a search and comparison tool to help you find certified home health agencies in your area. If you have original Medicare, Parts A and B, you can choose any approved agency.
If you have a Medicare Advantage plan from a private insurance company, you may have to use an agency that the plan works with. Before you start receiving care, the agency should let you know, verbally and in writing, whether some of the services they provide are not covered by Medicare and what you would pay for them.
Editor's note: This article was originally published on Jan. 1, 2014. It has been updated with the latest information regarding Medicare coverage in 2020.
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