Does Medicare Cover In-Home Care for Disabled Individuals?

Medicare doesn’t cover in-home care for disabled individuals, most times. The federal insurance program covers limited nonmedical care at home for any home health care recipient. Those needing regular home care, such as housekeeping and assistance with errands, must use other payment methods.

Original Medicare primarily covers older adults aged 65 and above. However, younger people with disabilities who receive Social Security Disability Insurance also qualify for Medicare coverage after a two-year waiting period. (Exceptions apply for those with end-stage renal failure and ALS, who receive coverage immediately.)

All Medicare beneficiaries must still meet home health care criteria to receive medical and therapeutic services in their homes. A doctor must certify individuals as homebound and prescribe services based on medical necessity. If they meet these requirements, people with disabilities can receive home health care services from Medicare-certified providers.

Home health care teams deliver diverse clinical and rehabilitative services in a person’s private home. Care plans commonly include:

• Skilled nursing care
• Physical therapy
• Speech therapy
• Occupational therapy
• Nutritional planning
• Medical social services
• Patient and family education

The insurance program pays for home health care aide support for those who also receive skilled in-home care. However, it doesn’t cover personal care assistance when individuals require no other care. Moreover, it never covers domestic help.

People who need home care services can’t rely on Medicare as a funding method. In most states, Medicaid covers nonmedical support at home for eligible individuals. VA benefits also fund home care for qualifying veterans. People should also consider:

• Long-term care insurance
• Reverse mortgages
• Bank loans
• Income and savings
• Family financial assistance