Many people wonder about Medicare coverage for in-home caregivers. Every day over ten thousand people are aging into Medicare; as they get older most want to stay home instead of going to an assisted living facility.
In a 2012 survey, that close to 90% of Medicare seniors don’t plan to move into assisted living. Unfortunately, as we get older we become less healthy. When this occurs we need higher levels of care.
In-home caregiver help with day to day functions
Many bodily functions worsen as we age such as vision, balance, muscle weakness, and hearing. The loss of these functions could lead to many risks causing a lack of mobility and the risk of falling, leading to injuries.
When these activities and bodily operations become more difficult, it can make basic household duties more challenging. Simple tasks such as laundry, cleaning up after yourself, and preparing food may become harder. Worse yet, impossible to do on your own.
Medicare doesn’t cover services such as laundry, shopping, cleaning, etc. If this is the only care you need, anticipate covering these costs personally.
Some people put enough money away to pay for an in-home caregiver to live with them full-time. You may want to consider finding a service that will deliver meals such as Meal on Wheels and a part-time cleaning service for which you pay out of pocket. Typically, Medicare doesn’t pay for meals to go to your home.
Some personal care may become increasingly difficult if you have a stroke or partial stroke, causing some level of paralysis. People that have suffered these afflictions will also have difficulty bathing, eating, dressing, other necessary tasks such as using the bathroom.
Medicare beneficiaries in this situation may get help from Medicare, as they will consider the help that assists with bathing, dressing, or other needs as custodial care. However, if that is the only care you need Medicare won’t cover these services.
Will Medicare Cover In-Home Care for Dementia
Dementia is the loss of cognitive functioning; thinking, remembering, and reasoning. This affects behavioral abilities to such an extent that it interferes with a person’s daily life and activities.
There are many cases that occur every year when a person with dementia wanders away, not remembering his/her address or name and becoming disoriented. If you have someone in your life that this could occur with you may want to consider 24-hour supervision by a caregiver that lives in-home.
Generally, Medicare won’t cover 24-hour care at home; you should consider long-term care insurance to help with these costs. Long term care policies are less expensive the younger you get them; also, you have to be healthy at the time in order to qualify.
Skilled Nursing Care
After surgery or other severe health events such as stroke or heart attack, many people want to recover in the comfort of home. They may need skilled nursing care.
Skilled nursing care usually falls under Medicare Part A and is covered in a skilled nursing facility for a limited time. Sometimes they may allow for occasional skilled nursing care at home.
If your needs require in-home caregiving, Medicare Parts A and B may cover other home health services including:
- Continued occupational therapy
- Physical therapy
- Speech/language pathology services
You must qualify to receive these types of services at home. The requirements generally are:
- Have Medicare Part A and Part B
- Receive care from a home health agency
- Your doctor must certify that you need pathology services, occupational therapy, or nursing care
- Must be getting services under a plan of care, regularly reviewed and under the care of your doctors
- Be homebound, this means leaving home isn’t an option or you have complications leaving home without help
Get Medicare Coverage for In-Home Caregivers
If your needs are more than intermittent care, you’re not eligible for home health benefits. It’s best to plan ahead and purchase insurance that covers nursing home or home health care before you need the coverage.
Give us a call at the number above to discuss your options. Or, if you prefer to compare rate online, fill out our online rate form.