Medicare and Long Term Care

What does Medicare pay for long term care and what does it not pay for?

Medicare pays for limited long-term care services, such as nursing home care, home health care, or hospice care. Medicare does not pay for extended custodial care, which is assistance with activities of daily living, such as dressing, bathing, and eating.

Medicare doesn't pay for:

• 24-hour-a-day care at home

• Meals delivered to your home.

Homemaker services

• Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need.

Home Health Care- Who's eligible?

All people with Part A and/or Part B who meet all of these conditions are covered:

• You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.

• You must need, and a doctor must certify that you need, one or more of these:

• Intermittent skilled nursing care (other than drawing blood)

Home health services How often is it covered?

To be eligible, either: 

1) your condition must be expected to improve in a reasonable and generally predictable period of time, or 

2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 

3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition.

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