Is Caregiving Covered Under Medicare? 5 Frequently Asked Questions
As a senior, you may want to hire a caregiver for medication management, in-home care, and perhaps additional services. If that's the case, you are probably wondering just how much of this expense is covered by Medicare.
Will Caregivers Be Covered under Medicare?
If you qualify for the home health benefit, Medicare will cover a home health aide in full if you require skilled care, such as personal care services and help with bathing and dressing.
Medicare will pay for your home healthcare if you are homebound, need skilled nursing services, or have a meeting with a doctor within 90 days before you start home healthcare or at least 30 days after you receive that care. This can be an office visit, a hospital visit, or even a video call in some cases. If your physician signs a form stating that you are homebound and require skilled care, your doctor should then review and recertify your home health plan every 60 days. A face-to-face meeting is not required.
What Programs Can You Use to Manage Any Anticipated Expenses?
There are quite a few resources and organizations for seniors who are looking for more information and additional ways to manage their expenses. Benefits Counseling is free and is available through your local Agency on Aging. AAA counselors will provide you with information regarding your healthcare coverage and other government benefits for seniors.
You may also want to look into the National Family Caregiver Support Program. AAAs often administer these programs in conjunction with other community-based organizations and providers. It's important to note, however, that these services are meant to supplement a professional caregiver, not replace one. Nonetheless, you can receive informal assistance when it comes to in-home care, support groups, training, and counseling.
Frequently Asked Questions
1. What Services and Care Will Medicare Pay for?
Medicare will pay for the following:
- Skilled nursing care to treat or aid in the recovery of illness
- Hospital stays related to injury and illness
- Physical and occupational therapy following injury and illness
- Hospice care
- Home health care that is medically necessary—this must be related to a specific injury or illness
- Outpatient services, such as doctor visits, diagnostic exams, and preventative care
- Prescription medications
- Medical supplies such as oxygen and catheters
2. What Are the Services and Care That Medicare Does Not Cover?
- Home health aids who assist with daily living
- Assisted living facilities
- Nursing homes
- Skilled nursing care that doesn't follow a hospital admittance—You should check with your doctor to see if this is available to you. Some accountable care organizations are allowed to waive the rule that requires a three-day in-patient stay before the patient has to stay at a skilled nursing facility.
3. Which Medicare Coverage Is Best for You?
You might be wondering which plan will best suit your needs. If that's the case, please note that Medicare Parts A, B, and D cover hospital care, outpatient services, and medication, respectively.
4. What Is Medicare Advantage?
Medicare Advantage is an excellent option because it covers at least as much as the original Medicare but often a lot more. There are quite a few benefits that Medicare Advantage offers its enrollees with chronic conditions, including:
- In-home support services
- Home Modifications—such as ramps, showers, and bathtub rails
- Transportation Services
That being said, it's important to note that Medicare Advantage plans often come with higher out-of-pocket costs and more limited provider networks than Original Medicare, a Medigap plan, and a Part D plan.
5. Will You Ever Be Able to Change Your Medicare Coverage?
Yes, you can change your coverage during Medicare's open enrollment period, which runs from October 15 through December 7 every year. During that time, you can switch from a Part D plan to another one or sign up for an Advantage plan if Original Medicare is not meeting your current needs.
It is essential to be as informed as possible when it comes to your healthcare coverage and, fortunately, you do have quite a few options for support if you know where to look.
Senior Helpers Racine Is Here to Help
Our Wisconsin-based Senior Helpers Racine offices provide personal care, companion care, and in-home care. We are located in Union Grove, Pleasant Prairie, and Kenosha. Please contact Senior Helpers Racine for more information. We are eager to assist you in every way we can.