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Does Medicare Cover Wound Care at Home?
Date Updated: December 9, 2024
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Yes, Medicare covers wound care at home for qualifying individuals as part of home health care packages. Both Types A and B cover home health services for those who meet homebound and medical needs requirements. A doctor must prescribe services and regularly recertify that they remain clinically necessary.
Basics of Wound Care
Wound care involves the management of all wound types, including deep cuts and punctures. People may have wounds following an injury, surgical procedure, burn or skin-related disease. After a doctor’s initial diagnosis and treatment plan, nurses or aides often continue related care tasks to promote healing. Individuals may need ongoing check-ups with their doctor. Typical wound care duties include:
- Administering topical medications
- Cleaning wound sites
- Removing dead tissue
- Changing dressings
- Hydrating the skin
- Monitoring wounds for infection and inflammation
- Checking healing progress
- Family and patient education
Wound care also includes managing associated conditions that impact healing and ensuring optimum health for recovery.
Overview of Home Health Care for Wound Management
Home health care companies use multidisciplinary professionals to provide part-time medical and rehabilitative care in private residences. Teams include certified nursing aides, nurses and therapists. When a doctor orders home health care, agencies design tailored support plans with input from medical providers, individuals and their loved ones. Services include skilled nursing, therapies and nutritional support; wound care falls under skilled nursing.
In addition to primary wound management, home health care plans address factors that can affect recovery. For example, because diabetes can slow the healing process, home health care services for wounds also include diabetes management. Other related care may include:
- Medication administration
- Pain management
- Nutritional guidance
- Physical therapy
- Lifestyle advice
Home Health Care, Wound Care and Medicare
Medicare pays the full costs of home health care, including wound care, for those who:
- Meet general Medicare eligibility requirements, including having paid sufficient tax credits and being at least 65 or having a disability or qualifying condition
- Satisfy homebound criteria
- Have a doctor’s prescription for such services and a physician deems them as medically necessary
- Receive care from Medicare-certified agencies
Those who can easily visit a clinic for minor wound management won’t qualify for home health care. On the other hand, individuals recovering at home from a major invasive surgery likely will.