What does Medicare cover?

Qualifying for home health benefits under Medicare is never guaranteed. Minimally, the patient must be:

• Homebound
• Under the care of a physician who requests and orders skilled care
• Needing skilled nursing or therapy on an intermittent (non continuous) basis

Note: Patient who requires more than intermittent care, but refuses other alternatives is not eligible  

• Examples of skilled nursing and therapy services that are usually covered by Medicare include: 
• Wound dressing involving prescription drug and aseptic techniques
• Bladder and bowel training in the case of incontinence
• Colostomy or Ileostomy care
• Injections or infusion therapies
• Physical, Occupational or Speech therapies

Medicare does not cover any private duty nursing costs. They also do not cover custodial care provided by home health aides for activities of daily living. A person may be very weak and unsteady and need help at home. They may require many support services such as bathing, grooming, dressing, assistance with ambulation, transferring from bed to chair, meal preparation and laundry. Medicare will not pay for these if all three of the guidelines listed on this page are not met.