If you are considering home health or hospice care for you or for a loved one, you may want to find out whether or not you are eligible for your home health or hospice services to be paid for by Medicare. Medicare is a Federal Health Insurance Program for people who are age 65 or older. Medicare also covers people under 65 with certain disabilities or people of any age who have end-stage renal disease. Medicare has two different parts: Medicare Part A – Hospital Insurance and Medicare Part B – Medical Insurance. Hospice and home health care usually fall under Part A.
How Does Medicare Establish Eligibility? The way Medicare determines whether or not a patient is Medicare eligible is finding out if the potential patient or patient’s spouse worked for at least 10 years in Medicare-covered employment. The patient’s eligibility is also determined by whether or not they are 65 years or older and a citizen or permanent resident of the United States. Even if a potential patient isn’t yet 65, they may still qualify for Medicare coverage if they have a disability or permanent kidney failure requiring dialysis or transplant.
Is Hospice Care Covered by Medicare? A patient is eligible for Medicare hospice benefits when:
- A patient is eligible for Medicare Part A (Hospital Insurance); and
- A patient’s doctor and the hospice medical director certify that a patient is terminally ill and probably have less than six months to live; and
- A patient signs a statement choosing hospice care instead of routine Medicare covered benefits for a patient’s terminal illness
- The person receives care from a Medicare-approved hospice program.
A patient’s doctor and the hospice will work with the patient and family to set up a plan of care that meets their needs.
Here is a list of the hospice services that Medicare covers:
- Doctor’s services
- Nursing care
- Medical equipment (such as wheelchairs or walkers)
- Medical supplies (such as bandages and catheters)
- Prescriptions drugs for pain relief and symptom control
- Short-term care in the hospital and respite care
- Homemaker services and home health aide services
- Physical and occupational therapy
- Speech therapist services
- Social worker services
- Diet and nutrition counseling
- Counseling to help a patient and a patient family with grief and loss
Medicare covers these hospice services and pays nearly all of their costs. A patient will only have to pay part of the cost for outpatient drugs and inpatient respite care.
Does Medicare Cover Home Health Services? Medicare Part A covers specific home health services. Medicare will cover the following home health services for patients:
- Part time or intermittent skilled nursing care by a licensed practical nurse or RN
- Personal care therapy
- Occupational therapy
- Medical supplies that are specifically related to your home health care plan such as wound dressings
- Resilient medical equipment
If there is a home health service that Medicare does not cover, instruct your home health care provider inform you as soon as possible so that you can properly plan for your home health expenses. This will help minimize any out of pocket expenditures you have before they are incurred.
Is There A Medicare Approved Hospice or Home Health Care Provider Near Me? If you’d like to locate a hospice or home health care provider that is Medicare-approved, you might want to ask your doctor, get information from a patient State Hospice Organization, or contact your State Health Department. If you live in Utah, you can contact Millcreek Home Health and Hospice as they are a Medicare approved hospice and home health care provider.
Many hospice and home health services are covered by Medicare. We hope that you will find a provider near you and that you or your loved one will get the Medicare covered services that are needed.
Learn more about Utah Home Health and Hospice Care here.
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