Are you, or someone you know, currently on or seeking home based care through your Medicare Insurance?
Because of your specific Medicare coverage options and/or private insurance plan you may be facing different challenges than others depending on where you live. Therefore, always check with a professional Medicare agent local to your area. OCmedicare.com experts work with individuals in California, specifically the southern California area.
PBS.org recently published an interesting article discussing Medicare and coverage for home based care. See full article here
“ One of the greatest gaps in Medicare coverage is that it does not help to pay for home-based care unless such care is requested by a physician as medically necessary. Medicaid will cover such long-term custodial care for people with little to no income or assets. But Medicaid covers fewer than one in five of the roughly 55 million people on Medicare, leaving the rest to fend for themselves or, for a small group of mostly better-off folks, purchase private long-term care insurance. ”
Like we have said before on this blog; Medicare can be a complex process. Determining your eligibility for in home coverage is no exception. Medicare home care benefits are limited for many seniors in need of this service.
What does this Medicare benefit cover?
The referenced article spells out their interpretation of the Medicare in-home care benefits. They point out that the benefits are much broader than advertised by the government handouts and website. Misleading and frustrating many a Medicare recipient.
“ Let’s begin with the benefit itself. According to the Center for Medicare Advocacy, Medicare will pay for up to 35 hours a week of home-based care — provided by nursing and home health aids — to people who are housebound and for whom such care is prescribed as medically necessary by their doctor or another authorized caregiver. The home health benefit also includes physical, occupational or speech-language therapy.
Skilled nursing care is covered on an “intermittent” and “part-time” basis and also for home-based medical social services and for home health aides, who are allowed to perform certain personal services that stem from the patient’s underlying medical needs, but which are not the same as custodial care, which is not covered by Medicare. “
Make a plan.
Medicare coverage laws have changed, and are changing, every year. It is important for you to educate yourself and stay tuned to current events regarding Medicare. Our resource page provides you a link to access the most current Medicare and You handbook. This is a great way to start analyzing and understanding the various benefits associated with Medicare.
Please read the full article (link found below) and decide for yourself how you will proceed if you are in the need of this benefit. Talk to those around you and develop a plan to help you receive the care you need, for the future or present.
Article By: Philip Moeller
May 3, 2017 at 2:13 PM EDT
See full article here
