Your Guide To What Home Health Services Are Covered By Medicare

When the senior in your life requires home health services in St. Louis following an injury or illness, their focus should be on getting better, not worrying about how to pay for the care they need. However, for those keeping a close eye on their life savings, it can be all they think about.

The good news? If your loved one is enrolled in Medicare, 100% of approved home skilled nursing and therapy services and 80% of durable medical equipment may be covered. Even if the unexpected affects their physical health in the short-term, it won’t affect their financial health in the long-term.

Need help talking with your parent or other family members?

Feel free to contact us today for a free in-home assessment. We can provide helpful suggestions that will make this difficult conversation a little easier.



Quality home health care is in your loved one’s reach

After a hospital stay, seniors have two options if they require rehabilitation. They can stay for the short-term in a nursing home, or they can return home to recover. It’s not surprising the majority of seniors want to get home as soon as possible. In fact, the psychological benefit they get from convalescing where they are comfortable is significant. A study featured in Social Work Today found that when compared to a nursing home, one-on-one skilled home care is less expensive (by up to 30 percent per day!), reduces the risk of complications, and helps prevent re-hospitalization.

Thankfully, Medicare covers both short-term rehab stays and skilled home care for anyone age 65 and older who is enrolled in the program, giving families more choices for care. Seniors are eligible to receive home health services through Medicare Part A. But only if they are homebound, have a doctor’s orders to receive skilled nursing care or therapy services, and are expected to improve following care. To learn more about home health services covered by Medicare or a Medicare managed care plan, contact an experienced skilled home care company.

Which skilled home health services are eligible under Medicare?

The overall goal of skilled home health care is to get your senior back on their feet sooner. It's also to make them as independent as possible. If a physician prescribes a care plan, Medicare will cover many of the following services:

  • Monitoring of the health condition through assessment and evaluation
  • Wound care
  • Intravenous therapy and injections
  • Intermittent skilled nursing care
  • Patient and caregiver education
  • Occupational, physical, and speech therapy
  • Custodial care assistance, like bathing or dressing, as it is delivered in conjunction with skilled nursing or therapy services
  • Medical equipment (80%)
  • All medical supplies necessary during the home health episode

Services not covered by Medicare include:

  • 24-hour-a-day care
  • Personal care not in coordination with skilled nursing services
  • Housekeeping services
  • Meal delivery
  • Prescription medications (patients will need to enroll in a Medicare Part D plan)

It is important to note that Medicare will only cover short-term rehabilitation services. If a senior requires long-term care, especially in an assisted living or skilled nursing facility, they will need to rely on Medicaid (MO HealthNet in Missouri), private insurance or pay privately.

Our experts are ready to help your family decode Medicare

As one of the top St. Louis home health services companies, Envision Health Partners knows how confusing navigating Medicare guidelines and restrictions can be. That’s why we staff our team with professionals who work to ensure your loved one can take full advantages of the options available to them – and avoid being stuck with a bill for those services they don’t need. By partnering with their medical team, our staff, and Medicare representatives, your loved one can focus on getting better.

To schedule a free Medicare assessment with Envision, contact us today.