Understanding Your Medicare Home Health Care Benefits

For many caregivers and families looking for more information on how they can care for their elders and loved ones, it can seem like a daunting task. One of the most important distinctions to make in your information search is knowing the difference between Medicare-covered Home Care and all other forms of home care. In this article, we will explain what Medicare Home Care is and how to find out if you or your loved one qualifies.

What is Medicare Home Health Care?

Home health care is the skilled nursing care and some other health care services you get at home to treat an illness or injury.

One of the services that Medicare provides to seniors is Home Health Services. Medicare beneficiaries must qualify for services and must be recommended by the individual’s primary care physician or specialty doctor.

Medicare beneficiaries who feel they may need Medicare home care should always investigate whether they really qualify for Medicare home health care services. It is not a general personal care or work at home service. Rather, Medicare home care covers limited care, specifically defined in the home related to diagnosed medical conditions, and sometimes includes personal care services.


These Medicare home care services must be prescribed by a physician and provided through a licensed home health agency. The beneficiary must have a medical condition, or a combination of conditions, that require periodic services from a nurse or a specialized therapist. A plan of care describing the specific services covered will be developed. Eligibility and coverage are strictly evaluated, so the beneficiary’s conditions and care needs must be fully ventilated.

Qualifications for Medicare Home Care

It is common for an elderly person to need assistance upon discharge from a hospital or rehabilitation stay as an inpatient. That individual’s physician, sometimes in concert with family members and the patient himself, would determine the need for home health care and complete the paperwork that refers the patient to home health care.

Other common situations include the slow physical decline experienced by older people; when that decline includes the inability to care for oneself on a daily basis – but care in a nursing home is not yet required – the physician may recommend home health care only for those tasks that the elderly cannot perform.

Eddie S. Roberts

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