Whitsyms can assist you in defining what Medicare may or may not cover.
Generally, Medicare does not pay for long-term care, however, Medicare may pay for a limited amount of home nursing care for Seniors. Whitsyms DOES provide that service.
After certain medical procedures Medicare may pay for a limited amount of skilled home health care services for patients over 65 years old, including but not limited to a Registered Nurse's visit, physical therapy, occupational therapy, respiratory therapy and social workers.
Personal care services including assistance with bathing, toileting, dressing, eating, walking and transfers are normally not covered by Medicare except as follows:
If you have Medicare, home health care services are covered if you meet all the following conditions:
Your doctor must decide that you need medical care at home, and make a plan for your care at home.
You must need intermittent skilled nursing care, physical therapy, speech-language therapy, or to continue occupational therapy.
The home health agency caring for you must be approved by the Medicare program (Medicare-certified).
You must be homebound, or normally unable to leave home without help. To be homebound means that leaving home takes considerable and taxing effort. You can be homebound and still leave home for medical treatment or short, infrequent absences for non-medical reasons, such as trips to a barber or church. A need for adult day care doesn't keep you from getting home health care.
Home health aide services on a part-time or intermittent basis. A home health aide doesn't have a nursing license, but supports the nurse by providing services such as help with bathing, using the bathroom, dressing, or other personal care. These types of services don't need the skills of a licensed nurse. Medicare doesn't cover home health aide services unless you are also getting skilled care such as nursing care or other therapy. The home health aide services must be part of the home care for your illness or injury.
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