Medicare: Do You Know All You Should?
At Home Nursing Care or Other Assistance
Medicare imposes strict limits in this area, since it is an area which may have great potential for abuse. Unfortunately, it is the area that, with careful scrutiny, could help the patient the most for the least cost. Currently, Medicare is limited to coverage for nursing care, physical, speech and vocational therapy, and certain home health aides. Again, all of the nuances of the various regulations, federal and state, are beyond the scope of this discussion, and are subject to change each year.
However, as an overview, there are certain requirements which must be met to provide At-Home Nursing Care covered by Medicare. First, the patient must be "homebound," which means that the patient requires assistance to leave the house. Second, the patient must need some type of "skilled nursing care" at least once a day for the covered period, which is defined as at least 60 days. Third, the patient must be under the treatment of a "Plan of Care" prescribed by a physician, and the agency providing the At-Home Nursing Care must be a licensed and certified Medicare provider.
If these requirements are met, Medicare will pay for up to 35 hours per week of such care. In addition, other items covered include medical equipment and such related expenses. Medical equipment must be prescribed by a physician. The section on Durable Medical Equipment more fully explains this coverage.
It should be understood that Medicare coverage will not extend to certain functions which are some of the most necessary to patients who may have trouble leaving the house. That means that cooking, cleaning, laundry, bathing, toiletries and related necessities are not covered by Medicare, nor is coverage contemplated under Medicare.