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Does Medicare Cover Home Health Care for Cardiac Rehabilitation?
Date Updated: December 13, 2024
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Medicare covers home health care for cardiac rehabilitation if an individual qualifies for general home health coverage. Doctors must prescribe services they deem medically necessary, and individuals must meet homebound requirements. However, specialized cardiac rehabilitation services fall outside home health services and take place in outpatient facilities.
Medicare Coverage of Home Health Care
Medicare covers diverse home health services for eligible individuals, and service providers must hold Medicare certification. Funding may come from Part A or Part B, covering total care costs. Services include skilled nursing, rehabilitation therapies and medical social services. Those receiving skilled care at home also qualify for personal care assistance from a home health care aide. Doctors must order in-home clinical services based on medical needs, and individuals must satisfy homebound criteria. This means they:
- Experience difficulties leaving their home because of injury or sickness
- Can’t leave their home because of the effort it involves
- Shouldn’t leave the home based on physician recommendations due to their condition
Care only continues for as long as a doctor prescribes it, and medical professionals must regularly reassess seniors’ needs. However, while the government insurance program covers cardiac rehabilitation, it doesn’t include such care in home health care packages.
Medicare Coverage of Cardiac Rehabilitation
Although individuals with heart conditions may qualify for home health care, specialized cardiac rehabilitation takes place outside the home. Individuals must visit outpatient facilities, such as hospitals or clinics. Part B of Medicare subsidizes cardiac rehabilitation; individuals have co-payments that vary depending on the treatment setting. Covered services include education, exercises and counseling for those with specific heart issues. Qualifying conditions include:
- A heart attack within the past year
- Current stable angina
- Heart or lung failure
- Stable chronic heart failure
- Specified heart surgeries