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https://www.cancer.org/cancer/managing-cancer/finding-care/home-care-agencies/who-pays.html
Medicare doesn't pay for:
- 24-hour-a-day care at your home
- Meals delivered to your home
- Homemaker services (like shopping and cleaning) that aren’t related to your care plan
- Custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need.
You're not eligible for the home health benefit if you need more than
part-time or "intermittent" skilled nursing care.
You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care."
Source: https://www.medicare.gov/coverage/home-health-services
My experience of cancer at age 47 was a different ballgame from cancer now at 81. I am now on Kaiser. WOW! I couldn't get rid of Ma Kaiser for months. I had assigned Social Worker, Nurse Manager, Oncology fellow, radiology followup, surgical followups and YOU NAME IT. Everything got discussed from how to notify of needs to how many steps are in my place, to what future wishes are scanned to chart. I honestly never experienced such thorough care.
So do check out everything. Medicare covers Hospice Care, and I think you may know that. Hospice today sure isn't what it once was and it's pretty rote and by the book, but good access and info, a few baths a week, a social worker, a clergy if wished, an RN once a week and equipment. All paid for by medicare. So not nothing.
Medicaid may have some inhome help and that's dependent on your own state's policies, rules, qualifications.
Good luck on your research for your area. I wish you the very best.
You are not going to get full or part time hours of care via Medicare, if that's what you're looking for. 24/7 care will come from family members or whatever patient can afford to pay for. If family can't provide the care ..free or paying for it... the next plan would be to figure out what level of facility care she can afford. Perhaps applying for Medicaid to assist with paying for a nursing home.
Sadly, in home care for our elderly is dependent on who in the family will help or how much money is available to hire caregivers. Not much middle ground.
Even hospice, if you use that option will not provide hours per day of care. They do a few things here and there and seem to respond quickly to questions or concerns, but won't do caregiving for and substantial period of time.
Medicare covers no more than 8 hours per day and 28 hours of week, up to 35 in certain circumstances, for skilled nursing and a home health aide combined.
The therapy visits are not subject to the 28 hour per week limitation, only the skilled nursing and home health aide visits.
Medicare does not cover a home health aide if that is the ONLY service you need and you are NOT homebound.
It seems many home health agencies don't realize what the
Medicare coverage rules are.
The Center for Medicare Advocacy has a great webinar that goes over Medicare coverage for home health services in great detail.
The best thing of all is Medicare covers these home health services at no cost.
For durable medical equipment and supplies, you pay the Part B deductible and 20% of the covered cost. This is for original Medicare. Medicare Advantage plans may be different.
If a home health aide is the only service you need, and you’re not homebound, then Medicare will not cover it. It's unfortunate that some home health agencies might not fully understand these coverage rules, so it's always helpful to educate yourself. For a deeper dive into these specifics, the Center for Medicare Advocacy offers a helpful webinar. Keep in mind that costs may vary if you're enrolled in a Medicare Advantage plan.