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Does Medicare Cover Home Health Care for Stroke Patients?
Date Updated: December 20, 2024
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Dr. Brindusa Vanta is a health care professional, researcher, and an experienced medical writer (2000+ articles published online and several medical ebooks). She received her MD degree from “Iuliu Hatieganu” University of Medicine, Romania, and her HD diploma from OCHM – Toronto, Canada.
Yes, Medicare covers home health care for stroke patients who meet eligibility requirements. The program pays the total costs of intermittent skilled nursing and therapies in an individual’s home for as long as a doctor certifies medical needs. However, Medicare doesn’t fund most day-to-day assistance with nonmedical tasks.
Qualify for Medicare Funding for Home Health Care After a Stroke
Individuals must satisfy Medicare’s general eligibility criteria as well as extra requirements specific to home health care services. People or their spouses must have made enough tax payments throughout their working lives to qualify for Medicare. Additionally, they must be at least 65 years old or have a disability, ALS or end-stage renal disease. Parts A and B of Medicare share eligibility requirements, and both cover home health care.
Home health care coverage depends on whether a doctor considers services a medical necessity based on a patient’s condition. Physicians must order services. Additionally, home health care recipients must be homebound. Only Medicare-certified providers can deliver medical or rehabilitative services in a person’s home. The nationwide insurance program only covers personal care when individuals also receive skilled care, and it never pays for general assistance in the home.
Home Health Care Services for Stroke Patients
Following a stroke, individuals often need a range of nursing and therapeutic services to aid their recovery. Hospitals may discharge those with stable conditions to heal at home with visiting support from trained medical professionals. Care is often short-term, and doctors must regularly recertify that services remain necessary for a person’s progress or well-being. Common home health care services for stroke patients include:
- Respiratory therapy
- Feeding tube management
- Continence care
- Medication administration
- Nutritional oversight
- Occupational therapy
- Physiotherapy
- Speech therapy
- Medical social services
- Patient and family education
- Personal care
Additionally, Part B of Medicare pays most costs associated with medical supplies and equipment for use at home, such as oxygen and mobility aids. It also covers certain drugs that manage stroke symptoms.
Other Care Types to Consider
Many people who’ve experienced a stroke require diverse medical and nonmedical support. Because Medicare only covers narrow aspects of regular home care, family caregivers often take on some household duties. Alternatively, individuals may contract with in-home care agencies to provide support with:
- Domestic chores
- Errands
- Transportation
- Meal preparation
- In-home enrichment
- Personal care on top of what Medicare covers
However, seniors without adequate support at home may be better candidates for nursing home care. Depending on the severity of their stroke symptoms, recovery and abilities, admission may be permanent or temporary. Such facilities monitor patients 24/7, deliver around-the-clock nursing care and provide tailored therapy programs. Those who have no ongoing clinical needs but require assistance with everyday activities find assisted living facilities more suitable.