Medicare and Home Care

Medicare covers care at home if the person is recovering from an acute illness, a doctor orders the services, or if the beneficiary is homebound. Coverage is available for people who need skilled, intermittent care. Intermittent care means fewer than seven days a week, or less than eight hours a day.

The coverage includes skilled nursing care and physical, speech, and occupational therapy. For example, a recovering stroke victim could get occupational therapy—assistance with learning anew how to handle the most essential activities of daily life, such as eating and getting dressed.

The coverage may also include the services of a home-health aide, who may help with bathing, dressing, or using the toilet. The home-health aide is a person who does not have a nursing license. The aide's work, assisting a patient with personal care, is not covered by Medicare if these are the only services a patient needs. However they are covered if the patient is getting skilled-nursing care or therapy services.

Example: Ms. Brown has had major surgery, is recovering at home, and her dressings must be changed twice a day by a nurse. She is bed-bound. A nurse is needed to change the dressings. But the patient may also receive help from a home-health aide who will bathe her.

A person can receive home care only if a doctor orders it, and if the person is “normally unable to leave the house.” Home care is limited to less than eight hours a day, and cannot exceed 28 hours a week.

For more information on Medicare and home care, see:

• Costs and Financing of Medicare Enrollees Living with HIV/AIDS in California, Medicare Brief No. 8

The official Medicare website is www.medicare.gov.