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Does Medicare Cover Home Health Aides?

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If you find that some day-to-day tasks are becoming too difficult to do alone, a home health aide may be able to help you. A home health aide may assist you in your own home, a group home, or a day service program.

What can a home health aide do for me?

According to the Bureau of Labor Statistics (BLS), a home health aide may be able to:

  • Help with personal care, such as bathing and dressing
  • Help with household chores, such as laundry, doing dishes, and vacuuming
  • Shop for groceries and cook
  • Coordinate transportation to doctor appointments

In addition, a home health aide may be able to provide very basic health services, depending on state regulations. A home health aide may be able to check your pulse, temperature, and respiration rate, according to BLS. Home health aides may also be able to give you medication under the supervision of a healthcare practitioner, such as a nurse.

How much does a home health aide cost?

According the Bureau of Labor Statistics, home health aides make on average, $11.12 an hour according to 2017 data. If you receive care from a home health aide 4 hours a day (28 hours a week), you could pay $311.36 a week or roughly $16,000 a year. In some areas, the cost of home health aides may be dramatically more.

Does Medicare cover home health aides?

As a general rule, Medicare only pays for medical care. This means that Medicare generally doesn’t cover personal care, such as bathing, dressing, and using the bathroom when this is the only care you need. Medicare also doesn’t generally cover “homemaker” services, such as shopping, cleaning, and laundry when this is the only care you need and these services aren’t related to your plan of care. Medicare may cover home health services if you meet the following conditions:

  • You must be getting services under a plan of care created by a doctor
  • You also must be one or more:
    • homebound (you have trouble leaving your home because of an illness or injury or it isn’t recommended that you leave your home because of your health condition) and a doctor must certify that you’re homebound
    • need intermittent skilled nursing care (other than drawing blood)
    • need physical therapy, speech-language pathology, or continued occupational therapy services

In addition, the home health agency caring for you must be Medicare certified. This means that if you hire a neighbor as a home health aide, Medicare may not reimburse you for this person’s services.

If your need for a home health aide is more medical in nature, Medicare may cover intermittent skilled nursing care. Intermitted skilled nursing care is defined as care that is fewer than 7 days a week or care for less than 8 hours a day for up to 21 days. However, if you need full-time skilled nursing care over an extended period of time (generally more than 3 weeks) Medicare usually won’t pay for home health benefits. Medicare may cover skilled nursing in a skilled nursing facility (not at your home) for up to 100 days. A coinsurance payment may apply.

Do you want to find Medicare coverage for a home health aide or skilled nursing care? Enter your zip code on this page.

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