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How Much Does Medicare Pay for Home Health Care per Hour?

Samara Davis
By Samara Davis
editor

July 20, 2021


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  • According to a United States National Care Planning Council study and Medicare experts from TruBlue of Centennial, Medicare pays for home health care per hour, varying from place to place. Generally, the standard amount per hour is $70 to $100 for nurses and therapists or social workers, while aides taking care of beneficiaries’ daily needs get $10 to $25 hourly. However, while Medicare pays for your home health care needs, it also covers only 90% of the costs hence the need to understand everything the program covers.

    What Is Medicare?

    Medicare is a federal health insurance program covering medical bills for individuals aged 65 and over, people with specific disabilities, and End-Stage Renal infections. It’s also for those with permanent ailments like kidney diseases requiring transplants and dialysis.

    Parts of Medicare You Should Know

    Generally, Medicare comes in three parts A, B, and D. Part A, typically referred to as Hospital Insurance, exclusively covers inpatient hospital bills like admissions, care in skilled nursing facilities, hospice care, and home health care services. Part B or the Medical Insurance covers specific medical practitioner’s services, medical supplies, preventive treatments, and outpatient care.  Part D or the prescription drug coverage covers the costs of prescribed drugs, including vaccines and other drug recommendations.

    What Is Medicare Home Health Care?

    Home health care is a broad range of healthcare services given in your home for injuries and illnesses that are more convenient and less expensive than the services you get in a hospital and other health facilities. Examples of home health care services paid for by Medicare include caregiver education and wound care comprising surgical wounds or pressure sores, injections, monitoring serious illnesses and unstable health statuses, and administering nutritional therapy.

    Qualifications for Medicare to Pay for Your Home Health Care Needs

    To be eligible for Medicare Home health care benefits coverage, you must meet all of the following requirements:

    Homebound

    Unless you’re unable to leave your home without considerable effort or aid from others or devices like walkers and wheelchairs, you’re not eligible for Medicare home health care benefits. The program offers home care benefits for patients in need of supportive health care services. Also, patients with conditions that quickly increase their severity and those with disabilities benefit more.

    Certified by a Medical Practitioner

    In addition to the inability to move from your home, the second qualification for Medicare home health benefits requires you to be certified by a professional doctor, nurse, or anyone working directly with doctors and nurses. They should affirm that you need intermittent health services from homes such as physical therapy, occupational therapy, nursing care, or more. Additionally, the certification should be on a face-to-face basis with the medical professional dealing with your condition no more than 90 or 30 days after the start of your home health care demands.

    Be Under a Plan of Care Regularly Reviewed By Health Professionals

    Besides being certified by a professional health care personnel and being home-bound, another consideration for Medicare Home health care benefits is if you’re under a plan of care established and regularly reviewed by nurses or doctors. Moreover, the plan should also include all the services needed, how often they are required, who should provide them, and the necessary medical supplies.

    Have Your Home Care Agency Approved By Medicare

    Lastly, benefiting from Medicare home health care services demand that the home health agency take care of your needs must be approved and accepted by the program before paying for your bills.

    How Medicare Pays For Your Home Health Care

    Generally, once you meet all the requirements for home health care services, Medicare starts paying for your medical bills after 30 days of care.  Payment for every 30 days is determined by your conditions and pressing health care needs.

    What Is Covered?

    If you’re eligible, Medicare home health care services will pay for the following:

    Nursing Care

    Medicare pays for nursing care services when your condition is medically approved for skilled nursing care needed for the comprehensive treatment and attention required for supportive treatment, especially for chronic diseases.  Nursing care includes services like drawing blood and regular health aid. Also, nursing care is paid for when your doctor recommends that you need specialized skills and the judgment of a professional nurse for physical and psychological therapy sessions. 

    Medical Social Services

    Medicare also pays for services when your doctor determines that you need help with social and emotional concerns that might help boost your recovery. In a nutshell, benefiting from Medicare home health care services demands you to consider factors such as if your home health agency is approved and understand the amount covered by the program. However, suppose you’re unable to leave your home or suffer from chronic infections like kidney failure. In that case, the Medicare program is the cheapest option for catering your medical bills compared to others like direct medical insurances.

    Likewise, consider reading: Top 7 Dental Insurance Companies of 2021 & Understanding Important Aspects of Maternity Cover Insurance

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