Top Ten Frequently-Asked Questions

Does Medicare cover home health care services?

• Yes, when ordered by a physician and the patient is continuing to progress, Medicare covers home health care.

Does Medicare pay for nursing homes/skilled nursing facilities?

• Yes, after a qualifying stay at a hospital, Medicare will cover a stay at a skilled nursing community for continued care and rehabilitation.

Does Medicare cover assistance with Activities of Daily Living (ADLs)?

• No, Medicare does not cover long-term care (i.e. assistance with ADLs). In some instances, Medi-Cal can assist with long-term care payments.

What is home health care?

• Home health care is a skilled level of nursing care (nursing, physical therapy, occupational therapy or speech therapy) at the individual’s place of residence.

What is palliative care at home?

• Palliative care is delivered by a specialized care team to ensure symptom management of a chronic illness. Palliative care can be given wherever an individual resides.

What is hospice at home?

• Hospice care is symptom management of a terminal illness when a patient is expected to have less than six (6) months to live. Hospice care is provided by an interdisciplinary team wherever an individual resides.

Does Medicare cover in-home care?

• No, in-home care is considered “long-term care” for assistance with Activities of Daily Living (ADLs) and is not covered by Medicare.

What is home care?

• Also known as “in-home care,” home care is when a caregiver comes into one’s home to assist with ADLs.

How much does 24/7 in-home care cost?

• Depending on the agency and location, 24/7 in-home care is approximately $22,000/mo.

Does Medicare pay for assisted living?

• No, because assisted living involves assistance with ADLs, it is considered long-term care, which Medicare does not cover.