If you are planning for either home health or hospice care, you may want to find out more about services that are covered by Medicare. Medicare is a Federal Health Insurance Program for people who are age 65 or older, people under 65 with certain disabilities or people of any age who have end-stage renal disease. Medicare has two parts: Medicare Part A - Hospital Insurance and Medicare Part B - Medical Insurance.
What Makes a Person Medicare Eligible? A person is eligible for Medicare if they or their spouse have worked for at least 10 years in Medicare-covered employment and the person is 65 years or older and a citizen or permanent resident of the United States. If the person applying for home health or hospice services isn't yet 65, they may qualify for Medicare coverage if they have a disability or permanent kidney failure requiring dialysis or transplant.
Are Hospice Care Services Covered by Medicare? Hospice care services are covered under Medicare Part A (Hospital Insurance). Medicare says that a person is eligible for hospice benefits when:
- The person is eligible for Medicare Part A (Hospital Insurance); and
- The person's doctor and the hospice medical director certify that the person is terminally ill and probably have less than six months to live; and
- A patient signs a statement choosing hospice care instead of routine Medicare covered benefits for a patient's terminal illness*; and (* Medicare will still pay for covered benefits for any health problems that are not related to a patient's terminal illness )
- The person receives care from a Medicare-approved hospice program.
Please keep in mind that Medicare will still pay for covered benefits for any health problems that are not related to a patient's terminal illness. A patient's doctor and chosen hospice care provider will coordinate with the patient and family to set up a plan of care that satisfies any special conditions or needs.
Here is a list of the hospice services that are covered by Medicare:
- Doctor services
- Nursing care
- Medical equipment such as wheelchairs or walkers
- Medical supplies (such as bandages and catheters)
- Medications for symptom control and pain relief
- Short-term care in the hospital and/or including respite care
- Homemaker services and home health aide services
- Physical therapist and/or occupational therapist
- Speech therapist services
- A social worker
- Diet and nutrition counseling
- Counseling to help the new patient and their family cope with grief and loss
Medicare covers these hospice services and pays nearly all of their costs. A patient will only have to pay part of the cost for outpatient drugs and inpatient respite care.
Are Home Health Services Covered by Medicare? Medicare Part A will cover home health services. The following home health services are usually offered to home health clients:
- Intermittent or part time skilled nursing care by a licensed practical nurse or registered nurse
- Personal care therapy
- Working with an occupational therapist
- Certain medical supplies that are related to your home health care plan, including wound dressings
- Resilient medical equipment
If there is a home health service that Medicare does not cover, instruct your home health care provider inform you as soon as possible so that you can properly plan for your home health expenses. This will help minimize any out of pocket expenditures you have before they are incurred.
How Can I Find A Medicare Approved Hospice or Home Health Care Provider? If you'd like to find out if a hospice program or home health care provider is Medicare-approved, ask a patient doctor, a patient State Hospice Organization, or a patient State Health Department. If you live in Utah, you can contact Millcreek Home Health and Hospice. They are a Medicare approved hospice and home health care provider.
Many hospice and home health services are covered by Medicare. We hope that you will find a provider near you and that you or your loved one will get the Medicare covered services that are needed.
Utah residents can find out more about home health care or hospice services by visiting Millcreek Home Health and Hospice's web site.
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