Navigating the world of aging parents or loved ones is an incredibly challenging and emotional feat. There are many new problems to face, none of which come with an instruction manual. When considering your senior healthcare options and insurance coverage, you must be fully educated on each option. This article will guide you through the different parts of Medicare and what in-home care for seniors is covered and which is not.
What Is In-Home Care for Seniors? 
In-home care for seniors is a service that helps make aging in place possible. Instead of moving your loved one to a facility, we focus on bringing benefits to your senior that allow them to remain in the home where they can feel comfortable, have their own space, and continue their routines. In-home care for seniors can include personal services, companion care, medical care, specialized need care such as memory care, and transitional or respite care. There are countless reasons why in-home care for seniors is a superior choice to moving into a nursing home or assisted living.
Can Medicare Cover In-Home Care for Seniors?
Medicare is federal health insurance for seniors aged 65 and older. This complex insurance has several different parts, each providing an additional service.
Medicare Part A: Hospitalization
Medicare Part A covers senior inpatient hospital stays. It also covers care in skilled nursing facilities, hospital care, nursing home care, and some home health care.
Medicare Part A And In-Home Care
Medicare Part A covers some in-home care for seniors. To receive Medicare coverage, a patient must be certified as homebound and under a doctor’s supervision. However, Part A provides coverage for at-home care for returning to your house after hospitalizations or stays in skilled nursing facilities. To be covered, you must be hospitalized for at least three consecutive days in inpatient care or have a Medicare-covered professional nursing facility stay. If your loved one meets the coverage requirements, Part A can cover your first 100 days of home health care. However, this care must begin within 14 days of discharge to be covered. Part A covers eligible in-home services such as intermittent skilled nursing care, physical therapy, other skilled therapists, and personal services.
Medicare Part B: Healthcare
Medicare Part B is primary healthcare. It covers doctor visits, outpatient care, medical supplies, and preventative treatments. Part B requires recipients to pay a monthly premium covering most preventative services by Medicare-accepting providers. This insurance covers all medically necessary services, supplies, or services needed for diagnoses and treatment, preventive services such as vaccines, and early illness detection testing. Part B covers ambulance services, mental health services, durable medical equipment, clinical research, inpatient and outpatient procedures, secondary opinions, and partial hospitalizations.
Medicare Part B And Home Health Care
The requirements to receive in-home care for seniors under Medicare Part B are that you are certifiably homebound and need skilled care. However, unlike Medicare Part A, there is no prior hospital stay requirement. Additionally, there is no deductible or coinsurance if your at-home care is covered by Part B. Part B also kicks in after the 100 days post-hospitalization have lapsed and all of the Part A coverage has been used. Medicare covers the total cost of certified expenses in either Part A or Part B.
These expenses can include skilled nursing services that can provide injections, tube feedings, catheter changes, observation and assessment, management of care, and wound care. Skilled nursing is covered by Medicare for no more than eight hours each day and 28 hours per week; however, some cases are covered for an additional seven hours each week.
Part B can also cover skilled therapy services, including physical therapy to regain body movement, strength, and mobility, speech therapy to regain speech and language skills, and occupational therapy to help recover the ability to perform daily activities. Any treatment required to treat your illness or injury can be covered as long as a licensed therapist performs it.
Medicare also covers a home health aide for patients receiving skilled nursing or therapy services. This home health aide performs personal care services, which include bathing, bathroom activities, dressing, and other essential tasks.
Part B pays for social and emotional services ordered by your doctor. This can include any counseling you need to recover emotionally and mentally from your illness and finding resources in your community for recovery. Medicare also funds medical supplies when provided by their home health agencies and durable medical equipment such as walkers or wheelchairs.
Medicare Parts C and D
Medicare Part C is a supplemental, private plan that can be added to other Medicare benefits. Recipients of Part C are Medicare Advantage Plans that combine parts A and B and are usually Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, or Medicare Medical Savings Account Plans. Most services will be covered under Part C, but items like hospice remain covered under Part A.
Medicare Part D is an addition to the original Medicare for prescription drug coverage. Part D plans are offered to patients by private insurance companies with the approval of Medicare. Their rules follow the same Medicare guidelines.
How Home Instead Can Help
Are you searching for information or resources to help your loved one live and age comfortably, safely, and happily? Home Instead is here to help! We have decades of experience navigating the ins and outs of senior care. We aim to help your loved one receive the best possible care they can while remaining happy and stress-free. We work with you on your loved one’s medical and lifestyle needs, mental health, personal preferences, and financial abilities to find the best way to care for your senior in place. Visit our website to check out our different service offerings, or schedule an in-home care consultation by filling out this form. We look forward to helping you simplify the complicated world of Medicare and in-home care for seniors.
