How much does Medicare pay for home care?

Medicare Home Care: Page 4

By , Caring.com Expert
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If a patient qualifies for Medicare coverage of home care, Medicare pays the full amount of the home care agency's charges, except for the rental cost of durable medical equipment such as a wheelchair or hospital bed, for which Medicare pays 80 percent. If a patient is enrolled in a Medicare Part C Medicare Advantage plan or has a Medigap insurance policy, that plan or policy may pick up this extra 20 percent for medical equipment; otherwise, the patient has to pay for it personally. The home care agency isn't allowed to bill patients for any amount above the Medicare-approved charges.

Medicare doesn't put any specific limit on the number of home care visits it will cover, nor on the total number of days a patient can be served by the home healthcare agency. But coverage will continue only as long as the patient meets all the qualifying conditions. A patient's condition and needs are regularly evaluated by the home care agency and by Medicare itself to determine how long skilled home care is medically needed and thus how long Medicare will keep paying.