Does Medicare Cover Palliative Care At Home?

Does Medicare Cover Palliative Care At Home?

it depends on the type of care you need. medicare covers some home health care services when you receive them in your home.

home health care services may include:

skilled nursing care

physical therapy

OT (occupational therapy)

speech language pathology

medical social services

medical supplies, equipment, and physical modalities

medicare does NOT cover home health care services if they are needed by someone who is at home primarily for:

rehabilitation services (such as physical, occupational, or speech therapy)

OT

home health care services are covered only when they are needed for medical reasons. this means that you must have a problem or condition that needs to be treated. for example, services are covered if you have a broken leg or a stroke. but they are not covered if you are recovering from surgery.

home health care services are also not covered if you need them only because of age or disability. this means that services are not covered if you need them only because of old age or another disability. this is true even if you don't need skilled nursing care, OT, or medical supplies, equipment, or modalities.

home health care services are also not covered if you are getting them at home primarily to allow you to:

learn about or be trained for a job

make it easier for you to travel, take a vacation, or go to school

make it easier for you to do your job

cover the cost of home health care services

learn how to live independently

if you need help with daily activities, medicare does NOT cover the cost of home health care services. this is true even if you also need skilled nursing care, OT, or medical supplies, equipment, or modalities.

what do i need to know about medicare's home health care coverage?

if you need home health care services and medicare covers them, you or your family members may have to pay a premium and/or a deductible. the premium and deductible will depend on:

the type of home health care services you need

your income

your status as a:

medicare beneficiary if you are entitled to part a and enrolled in part b

medicare beneficiary if you are not entitled to part a

medicare beneficiary enrolled in part b

medicare beneficiary enrolled in part a and enrolled in part b

for more information on premiums, deductibles, and how much you will have to pay, please see “coverage for home health care services” in the medicare and you handbook.

do i have to sign a home health care plan?

yes. medicare requires you to sign a plan of care for home health care services. a plan of care is a written agreement between you and the home health care agency. it lists the home health care services you need and the amount of time you need them.

when should i sign the home health care plan?

you should sign the plan of care whenever you agree to receive home health care services. this agreement is called an individualized plan for home care (ipc). you should sign the ipc at the beginning of home health care services so that you know what services you will receive.

can i change my mind?

yes. you can change your mind at any time. but remember, if you decide to change your mind, you will have to stop receiving home health care services. if you stop receiving home health care services, you may have to pay for them.

how long does the home health care plan last?

the length of the ipc will depend on the amount of time you need home health care services. for example, if you need home health care services for 30 days, the ipc will last for 30 days.

if you need home health care services for a longer period of time, you will need to sign a new ipc at the beginning of each month.

if you don't need home health care services for the full amount of time mentioned in the ipc, you should:

call the home health care agency and ask if you can receive services for a shorter period of time

talk to the home health care agency to find out how to stop getting services

if you want to cancel services before the ipc ends, you will have to pay the home health care agency for the rest of the month.

what happens if i move or get sicker?

if you move, you must tell the home health care agency. if you get sicker, you must tell the home health care agency. if you don't tell the home health care agency, the agency won't know that you need more or less care. as a result, the agency may send you services you no longer need.

can i choose who provides my home health care services?

yes. you can choose who provides your home health care services. you can choose the home health care agency you want to use. you can also choose the type of home health care services you want.

what if i'm not happy with home health care services?

home health care services should meet your needs. if you are not happy with services, you can ask for changes, or for them to be improved. you can also ask for a different home health care agency to provide services.

if you are still not happy with services, you can ask for a new home health care plan.

for more information on how you can change home health care services, please see “how to change home health care services” in the medicare and you handbook.

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