Navigating Home Health Services: Aging in Place with Confidence
As more seniors choose to age in place, home health agencies have stepped up to provide skilled care at home through licensed nurses and therapists. These services offer a vital lifeline for seniors, delivering effective medical care while maintaining their independence in the comfort of their homes. When prescribed by a doctor, home health services are often covered by Medicare, private insurance policies, veterans benefits, or long-term care (LTC) insurance.
This guide explores the services Medicare covers and how families can make informed decisions between home health care and skilled nursing facilities based on individual needs and safety.
What Home Health Services Does Medicare Cover?
If you qualify for the Medicare home health benefit, the following types of care are available:
1. Skilled Nursing Services
Medicare covers skilled nursing services for up to 7 days per week, with a maximum of 8 hours per day and 28 hours per week (up to 35 hours in special cases). These services include tasks that require the expertise of a licensed nurse, such as:
- Injections or teaching self-injection techniques
- Tube feeding or catheter changes
- Wound care management
- Patient assessments and adjustments to care plans
2. Home Health Aides
Medicare will provide a home health aide if skilled nursing care or therapy services are required. Aides assist with personal care, such as:
- Bathing and dressing
- Using the toilet
However, if personal care is the only service needed, it will not qualify for Medicare coverage. For example, Medicare will cover an aide for someone recovering from a fractured bone who is also receiving physical therapy at home.
3. Skilled Therapy Services (PT, OT, Speech Therapy)
Medicare covers therapy services provided or supervised by licensed professionals, such as:
- Physical therapy: Gait training and exercises to restore movement and strength
- Speech therapy: Exercises to improve communication skills
- Occupational therapy (OT): Support for regaining daily activities, such as dressing and eating
Medicare will continue covering therapy even if it is needed to maintain the patient’s condition, not just to improve it. However, OT alone does not qualify for the home health benefit unless combined with other eligible services.
4. Social Services
Social workers provide counseling and help connect patients with community resources. Medicare covers these services to address the emotional and social challenges related to an illness or injury.
5. Medical Supplies and Equipment
Medicare covers necessary medical supplies such as wound dressings and catheters. For durable medical equipment (DME), like wheelchairs, walkers, and bedside commodes, Medicare pays 80% of the approved amount.
What Medicare Does Not Cover in Home Health Care
While Medicare covers many essential services, there are limitations to be aware of:
- 24/7 in-home care is not covered.
- Prescription medications must be covered under Medicare Part D or provided by a facility if the patient is in a skilled nursing facility (under Medicare Part A).
- Meal delivery services are not included under home health benefits.
- Housekeeping and custodial services (like grocery shopping and cleaning) are only covered in a skilled nursing facility, not at home.
How to Choose Between Home Health and Skilled Nursing Facilities
Deciding whether a patient should recover at home or in a skilled nursing facility involves input from doctors, social workers, and therapists, as well as the patient’s family. Here are some factors to consider:
- Availability of 24-hour care: If the patient lives alone or lacks round-the-clock support, a skilled nursing facility may be the safest option.
- Support from family or caregivers: Patients with family available to assist during recovery may benefit from home health services, allowing them to remain in familiar surroundings.
- Cognitive challenges: Seniors with dementia or Alzheimer’s may struggle with multiple transitions between a hospital, rehab, and home. In such cases, remaining at home with skilled services may be more beneficial.
Planning for the Future: Supporting Aging in Place Safely
Understanding the options available is essential for families supporting seniors who wish to age with dignity and respect. Home health care offers a personalized alternative to facility-based care, promoting independence while meeting medical needs.
At Concierge Care Advisors, we guide families through every step of the journey, helping them evaluate the best care options—whether that involves home health, assisted living, or skilled nursing care. Call us at 1-855-444-7364 or fill out this form to speak with a Senior Living Advisor and explore the possibilities for your loved one’s future.
