There are important differences in coverage between home health care and nursing home care. The most crucial difference is that home health care can be covered by Medicare, whereas long-term care services in nursing homes are not. For a long-term nursing home, care is typically defined as non-medical custodial, which is not covered by Medicare.
Original Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services like these:
- Part-time or “intermittent” skilled nursing care
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Part-time or intermittent home health aide services (personal hands-on care)
- Injectible osteoporosis drugs for women
- Usually, a home health care agency coordinates the services your doctor orders for you.
Original Medicare doesn’t pay for:
- 24-hour-a-day care at home
- Meals delivered to your home
- Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
- Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need.
The exact benefits and copays, coinsurance, and deductibles you are responsible for vary depending on whether you are enrolled in Original Medicare, Medicare Advantage, or a Medicare Supplement.