Medicare. If you are older than 65, you are probably eligible for the federal Medicare program.
Patients who are unable to be active outside the home, under a healthcare provider's
care, and in need of medically necessary skilled nursing or therapy may be eligible
for Medicare coverage. A healthcare provider must authorize and at different times review
the home healthcare plan of the person. Home healthcare services covered by Medicare
must be part-time. It must also be provided by a Medicare-certified home health agency,
or an agency that meets the minimum federal requirements of care and cost. Hospice
care coverage by Medicare requires certification from a healthcare provider that the
patient is terminally ill.
Medicaid. Medicaid is a joint federal-state medical assistance program for low-income individuals.
Eligibility differs from state to state. However, all states are required to provide
home healthcare coverage to people who:
Receive federally assisted income maintenance payments, like Social Security income
or Temporary Assistance for Needy Families.
Are determined to be "categorically needy." Categorically needy individuals are those
people who are aged, blind, and are disabled with incomes too high to qualify for
coverage below the federal poverty level. Under the federal Medicaid rules, coverage
of home health programs must include services, like part-time nursing, healthcare
agency services, and medical supplies and equipment. Some states may provide audiology,
physical, occupational, speech therapies, and medical social services as well. Medicaid
hospice care coverage is essentially the same as Medicare.
Older Americans Act. The Older Americans Act funds state and local social service programs for frail and
disabled older individuals to continue independent living in their communities. Coverage
may include home healthcare agencies, personal care, and assistance with chores, meals,
and shopping. Individuals must be ages 60 and older. This act expired in 2011. Currently,
the "Older Americans Act Amendments of 2015" is up for Senate review.
Veterans Administration. Home healthcare is given for veterans through the Veterans Administration if the
individual is at least 50% disabled as a result of a service-related injury or illness.
Authorization from a healthcare provider is needed. Services must be given through
the Veterans Administration's hospital-based home care units. Nonmedical home healthcare
services are usually not covered under this provision.
Social services block grant programs. On a yearly basis, federal social services block grants are awarded to the states
for service needs. Some of these funds are given to home healthcare agencies and homemaker
or chore worker services. Individuals may contact their state health departments and
offices on aging for more information.
Community organizations. Some community organizations may pay for all or part of the necessary home health
or hospice care services. This depends on a patient's eligibility and financial circumstances.