Here’s the good news: Depending on the type of in-home senior care that you need, Medicare may pay for some or all of the costs. Of course, there is a detailed and comprehensive list of covered services. So, to start, let’s take a look at what Medicare won’t pay for.
According to the medicare.gov website, here is what the government insurance won’t cover.
- 24-hour-a-day care at home
- Meals delivered to your home
- Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
- Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need
Why Does Medicare Only Pay for Certain Services?
Medicare isn’t meant to be a long term solution for in-home senior care. The goal is to provide seniors with skilled services in their homes, a place that’s more comfortable compared to the alternative – recovering in a hospital or a nursing facility. That’s why services Medicare pays for must be certified and verified by a doctor. The physician also needs to come up with a plan for the duration and frequency of the service.
What Does Medicare Pay For?
Medicare will cover skilled nursing services and skilled therapy services. Nursing services include things like:
- Putting in or taking out a catheter
- Taking vital stats
- Wound care
- Intravenous drug therapy
- Patient education sessions
Basically, these are medical procedures that the regular, unskilled caregiver is not qualified or comfortable performing.
Skilled therapy services include physical therapy, occupational therapy and speech-language therapy. The goal of all three is to help seniors live as independently as possible.
Physical therapy may include things like helping you walk. Occupational therapy focuses on daily skills that they need to be relearned. And speech-language therapy that helps seniors regain speaking or even swallowing abilities.
You’ll need to first find a Home Health Provider. The agent will be able to tell you what Medicare will pay for and what it won’t. As the government Medicare website notes: “[The services Medicare pays for] should be explained by both verbally and in writing. The home health agency should give you a notice called the Advance Beneficiary Notice” (ABN) before giving you services and supplies that Medicare doesn’t cover.”