What Does Medicare-Funded Home Health Care Cover?

If you have Medicare, you can use your home health benefit to pay for a variety of services including skilled nursing, physical therapy, occupational therapy, speech therapy, home health aides, and more. Here’s what you need to know about Medicare-funded home health care. 

Skilled nursing is a common service that’s covered by Medicare, and it’s a requirement if you want to receive coverage for a home health aide. Qualifications for skilled nursing coverage include: 

1. Services must be reasonable and necessary for the treatment of your illness or injury
2. Services must be given on a part-time or intermittent basis (fewer than 8 hours each day; 28 or fewer hours each week or up to 35 hours a week in some situations)

Physical therapy, occupational therapy, and speech-language pathology services must be reasonable and necessary in the home setting. In order to receive coverage, the services must meet these criteria: 

1. Services must be specific, safe, and effective treatment for your condition 
2. Services can only be safely and effectively performed by a qualified therapist 
3. Services consist of a professionally designed therapy program that is required to restore or improve functions affected by your condition and prevent your condition from getting worse 
4. Services must be given in a reasonable time and frequency 

Home health aide services may also be covered, provided they meet these qualifications: 

1. Services must be given on a part-time or intermittent basis (fewer than 8 hours each day; 28 or fewer hours each week or up to 35 hours a week in some situations)
2. Patient must be receiving skilled care including skilled nursing care, physical therapy, speech-language therapy, or continuing occupational therapy

It’s important to know that Medicare does not pay for:

• Full-time (24 hours a day) care at home
• Meals delivered to your home
• Homemaker services
• Personal care

Learn more about the home health services offered at Santé. Specialized programming is available for those with COPD, pain, and congestive heart failure.

For more information about how to qualify for home health care services offered at Santé, please call 480.264.4568 or contact us online.