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Does Medicare Cover Home Health Care for Cancer Patients?
Date Updated: December 20, 2024
Written by:
Lauren Ferguson has over five years of experience as a freelance writer, specializing in senior care topics such as assisted living and memory care. She holds a degree in Liberal Studies and English from the University of Illinois Springfield. Having navigated the process of placing her mother in a long-term care community, Lauren offers a unique insider's perspective to families facing similar situations.
Reviewed by:
Kristi Bickmann, a licensed Long-Term Care Specialist, represents top-rated "Traditional" & "Hybrid" LTC companies. Serving associations such as the American Nurses Association, she's a licensed insurance agent in 27 states. Specializing in insurance products for seniors, Kristi helps hundreds of families every year protect assets, retirement, and loved ones. She understands aging concerns firsthand, having assisted her own parents. Kristi ensures accuracy on topics about senior long-term care and its consequences.
Yes, Medicare covers home health care for cancer patients if they meet specific eligibility criteria, such as being homebound and needing skilled nursing services. This type of care allows individuals to receive medically necessary support at home, helping manage symptoms and improving their overall well-being.
Home Health Services Medicare Covers
Home health care offers nonmedical assistance and some nursing services directly in the homes of patients with homebound status, as determined by their physician. It typically costs less than care provided in hospitals or skilled nursing facilities while maintaining similar effectiveness. Medicare covers a range of home health services, including:
- Intermittent nursing care
- Physical and occupational therapy
- Speech-language pathology services
- Provision of medical equipment and supplies
- Limited home health aide care, including assistance with eating and grooming, when provided in addition to therapies or skilled nursing
Cancer patients often benefit significantly from skilled nursing care and physical therapy. Nursing professionals administer medications and monitor vital signs, as well as manage cancer symptoms and the side effects of some intensive treatments. Physical therapy, on the other hand, can help individuals regain strength and improve mobility, contributing to a better quality of life during and after treatment.
Who Qualifies for Home Health Care?
Medicare Part A or Part B covers the full cost of eligible home health services. However, patients need to pay 20% of the Medicare-approved amount for durable medical equipment. To receive home health care under Medicare, you must meet all the following requirements:
- Your doctor or authorized health care provider must oversee your care. They must establish and periodically review a care plan that includes the services you receive.
- Your provider must certify your need for at least one of the following: intermittent skilled nursing, physical therapy, continued occupational therapy, speech-language pathology services or home health aide care.
- You must obtain care from a Medicare-certified home health agency.
- Your doctor must certify your homebound status. This means that your condition limits your ability to leave home without considerable effort or assistance.
- Your provider must document a face-to-face meeting with you related to the reason you need home health services.