Most Americans over the age of 65 may qualify for home health care financial assistance in Illinois through the Home Health Care Benefit under Medicare and Illinois Medicaid program. Housebound seniors requiring medically necessary skilled nursing or therapy may qualify for services provided by a Medicare-approved home health care agency. Medicare may provide funding for part-time nursing assistance, rehabilitation therapy and necessary medical equipment. Services must be authorized by the referring physician and periodically reviewed according to their care plan. Medicare covers certain tasks performed by a nurse, therapist or home health aide inside eligible seniors’ homes. In contrast, Illinois’ Medicaid program will cover home care costs and other in-home supportive services if they meet the necessary guidelines.

Medicare Home Health Care Benefits and Eligibility Requirements

Medicare Part A and Medicare Part B cover eligible home health services such as, intermittent skilled nursing care, rehabilitation services (physical, occupational and speech therapies), medical social services, part-time home health aide care (other skilled services, including nursing and/or therapy, must also be provided concurrently), durable medical equipment and medical supplies for home use. Medicare does not cover around-the-clock home care, home-delivered meals, homemaker services not related to personalized care (shopping, cleaning, laundry) and custodial or personal care that helps with daily living activities (bathing, toileting, dressing), when this is the only type of care needed.

Older adults who carry either Part A or Part B and fulfill all the necessary criteria are covered. Requirements include being under a doctor’s supervision and receiving services as indicated under a plan of care created and periodically reviewed by a physician, a doctor’s certification of need for limited skilled nursing care or physical, speech and occupational therapies directly related to the treatment of specific conditions, and a physician’s certification stating their patient is homebound.

Home Services Program and How to Qualify

The Home Services Program (a Medicaid waiver) offers assistance to people with severe disabilities to help offset the cost of home health care. HSP services include a personal assistant, homemaker services, maintenance home health care, emergency response systems, home delivered meals, adult day care, assistive equipment, environmental modifications and respite care.To receive assistance, individuals must meet certain eligibility requirements. Applicants must be under the age of 60, have a serious disability, be at risk of nursing home placement, apply for Medicaid or already be Medicaid eligible, require in-home services equal to or less than nursing home costs, be a resident of Illinois with U.S. Citizenship, meet asset limit guidelines and meet the Determination of Need points requirement. Seniors at least 60 years old and above can contact the Illinois Department on Aging for more information.