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Does Medicare pay for in home care?

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If a person is actually checked into a hospital and remains for three or more nights, they may qualify for in-home care services delivered by a Home Health Care Agency. The key to eligibility is two-fold: Did the older adult actually get admitted to the hospital, or were they simply there "under observation." Some seniors and their families aren't aware that a multiple day stay in the hospital may not necessarily equate to an admission. Unless the older adult is actually "admitted," and unless three full nights are spent in the hospital, Medicare benefits are not applicable upon discharge from the hospital.

A physician or ARNP must prescribe in-home care, and Medicare must view it as "medically necessary" by both the health care professional and Medicare.

Most in-home care is provided as an alternative to or as an extension of skilled nursing care. A senior must have a medical need to recuperate, to receive treatments or therapies, and be capable of showing improvement in condition.

People with dementia are less likely to receive in-home care coverage, as a person must be able to retain information and be capable of putting recommendations of the visiting health care professional into practice.

CHOICE Advisory Services is a FREE senior care referral agency.

We help define the options that will be of greatest interest to you.

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Last update: 2013-02-19 22:04
Author: Tech Support
Revision: 1.2

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