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Does Medicare Cover Home Health Care for Medication Management?
Date Updated: December 13, 2024
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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.
Medicare covers home health care for medication management services included in your physician-approved care plan. Your condition must prevent you from leaving home and require skilled nursing or rehabilitative care. If a doctor deems certain medications necessary to manage or treat your condition, they document that information in your care plan.
How to Qualify for Medicare-Covered Home Health Benefits
Medicare Part A and Part B cover medically necessary part-time or intermittent home health care for homebound individuals. To achieve homebound status, you must meet one of three requirements. You must:
- Need assistance from another person or a mobility device, such as a walker or wheelchair, to leave home due to an illness or injury
- Receive advice from a doctor to stay home due to your condition
- Find that leaving home requires a major effort
A doctor must conduct an in-person visit and certify your condition requires home health care to maintain quality of life. They develop an individualized care plan to share with a Medicare-certified agency. Your care plan may include medication management services related to your condition.
What Medication Management Services Does Medicare's Home Health Benefit Cover?
Under the home health benefit, Medicare covers a range of medication management services, including:
- Administering medications: This includes checking proper dosages, applying medical ointments and giving injections as prescribed.
- Monitoring medication effects: A home health aide monitors your response to medications and consults a trained nursing professional to report concerns or request adjustments as needed.
- Educating patients and caregivers: The agency provides education regarding prescribed medications, including proper dosages, potential side effects and interactions, to enhance your safety.
- Assessing patient capabilities: As your condition and needs evolve, attending aides and nursing staff monitor your ability to manage medications independently and offer support when needed.
Medicare's home health benefit only covers medication management services deemed medically necessary for your qualifying condition. Additionally, it doesn't cover 24-hour monitoring or care.
Does Medicare's Home Health Benefit Cover Medication Costs?
Although Medicare's home health benefit covers medication management, it doesn't offer financial assistance for prescription drugs or over-the-counter medications and supplements. However, Medicare Part D covers prescription medications and pairs with other insurance plans. For example, you can enroll in Medicare Part D to alleviate prescription costs and Part A or Part B to coordinate medication management and administration services through home health care.