Medicare will cover in home care if the person has a skilled nursing need. Usually home care is ordered after an acute episode like a hospitalization and the person is discharged with a need for skilled services - SN, PT, OT. until they get more independent. A PCP can write homecare orders as well without a hospitalization. When the order is written to a homecare agency a nurse makes the initial visit/assessment and then determines what services are needed. Those orders are co-signed by the doctor. A homecare episode usually last 60 days. If a HHA (home health aide) is available they can come out once or twice a week for hygiene assistance. HHA is the hardest position in homecare to fill because one area has only one HHA and that person can’t accommodate everyone. We had a huge turnover for this position. I remember every family wanted the HHA in the morning but this could not be promised & then the families were upset with the HHA. Medicare will not pay for home health bath aid after the 60 days are up or on a regular basis. Be aware some supplemental insurances do not cover a HHA meaning Medicare may cover 80% but the person will need to pay the 20% if the supplemental doesn’t cover it. In my recent experience as a CM I have seen this a lot with non Medicare(Commercial payors) and Medicare patients alike. Many Supplemental & primary commercial plans are not covering HHA services . Check with your secondary insurance about the HHA coverage as their customer service department will know for sure.
If you are talking about visiting doctors, yes Medicare will cover that once certain criteria is met.
If you are talking about an aide that is just there to help and do whatever day after day, probably not.
If you are talking about physical therapy and occupational therapy, if it is prescribed by the doctor, yes.
Depending on the physical condition you can get some in home help for bathing.
Everything will need to be prescribed by the doctor, once you get one home visit you will be able to work with that company to find out what you can get through your Medicare and supplemental.
Be more specific what you are looking for and what's needed. It is physical therapy that's needed? Or is it help with medicines and bathing? Blood pressure checks? Meals and/or meal prep? I agree that you should call the Agency on Aging, but be ready to tell them exactly what you need and how long you anticipate needing it. The phrase "in-home care" encompasses a lot of things and scenarios, so try to narrow it down a little so people know how to direct you. I have found Medicare covers very little in-home stuff and what they do provide in-home is temporary anyway. Your other health insurance will be able to tell you what they cover, but be ready to tell them exactly what you need.
Are you hoping to find 24/7 in home care that is paid for by Medicare? You will not find it. If there is a long term care policy purchased separately that policy may pay. Medicaid most times will not pay for 24/7 either.
I see you are in Michigan. Call the Area Agency on Aging. Michigan Medicaid rules are very different.
The answer is complicated And it’s not a yes or no answer. You should be asking Medicare and whatever ever insurance company is involved. Medicare doesn’t really cover home care, this year they’ve cut back way they cover in the way of home care. They cover intermittent care after a hospitalization. they may cover a home health aid that wouldn’t really do much except bathe the person. They will not pay for regular full time home care. As far as other insurance, it depends entirely on what the policy covers.
A PCP can write homecare orders as well without a hospitalization.
When the order is written to a homecare agency a nurse makes the initial visit/assessment and then determines what services are needed. Those orders are co-signed by the doctor.
A homecare episode usually last 60 days.
If a HHA (home health aide) is available they can come out once or twice a week for hygiene assistance. HHA is the hardest position in homecare to fill because one area has only one HHA and that person can’t accommodate everyone. We had a huge turnover for this position. I remember every family wanted the HHA in the morning but this could not be promised & then the families were upset with the HHA.
Medicare will not pay for home health bath aid after the 60 days are up or on a regular basis.
Be aware some supplemental insurances do not cover a HHA meaning Medicare may cover 80% but the person will need to pay the 20% if the supplemental doesn’t cover it.
In my recent experience as a CM I have seen this a lot with non Medicare(Commercial payors) and Medicare patients alike. Many Supplemental & primary commercial plans are not covering HHA services . Check with your secondary insurance about the HHA coverage as their customer service department will know for sure.
If you are talking about an aide that is just there to help and do whatever day after day, probably not.
If you are talking about physical therapy and occupational therapy, if it is prescribed by the doctor, yes.
Depending on the physical condition you can get some in home help for bathing.
Everything will need to be prescribed by the doctor, once you get one home visit you will be able to work with that company to find out what you can get through your Medicare and supplemental.
I see you are in Michigan. Call the Area Agency on Aging. Michigan Medicaid rules are very different.