"Home Care" 

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Home Care is typically an agency, engaged in providing home care services to clients in their residence. 

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What Services are Included in Home Care?

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Home care services include but are not limited to:

• Personal care, including assistance with dressing, feeding, and personal hygiene to facilitate self-care;

• Homemaker assistance, including housekeeping, shopping, meal planning and preparation; or

• Respite care and assistance and support provided to the family.

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What Services are NOT Included in Home Care?

•  Management of the client’s money or finances, or the balancing of the client’s checkbook; or

• Nursing services or other clinical professional services normally provided by home health agencies or private duty nursing services

 

Who is Eligible?

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All people with Part A and/or Part B who meet all of these conditions are covered:

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• You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.

• You must need, and a doctor must certify that you need, one or more of these:

  • Intermittent skilled nursing care (other than drawing blood)

  • Physical therapy, speech-language pathology, or continued occupational therapy services. These services are covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition. The home health agency caring for you is approved by Medicare (Medicare certified).

• You must be homebound, and a doctor must certify that you're homebound.
  You're not eligible for the home health benefit if you need more than part-time or "intermittent" skilled nursing care.You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care.

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Your costs in Original Medicare:

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• $0 for home health care services If qualified

• 20% of the 

  Medicare-approved amount for durable medical equipment (DME)

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