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How long can I get home health services?

How long can I get home health services?

Medicare will pay for home health services for as long as you are eligible and your doctor says you need these services. However, skilled nursing care and home health aide services are paid for only on a part-time or "intermittent" basis. This means there are limits on the number of hours per day and days per week that you can get skilled nursing or home health aide services. Medicare will only pay for intermittent care, defined as services given on fewer than 7 days each week, or less than 8 hours each day over a period of 21 days (or less).

Example: Jane's doctor says that she needs a nurse to visit her every day for the next 15 days to care for a wound. The nurse will be at Jane's house for less than an hour each day, and Jane only needs the nurse to come for 15 days. Jane's need for home health care meets the Medicare definition of "intermittent."

Hour and day limits can be increased by your doctor in special cases the number of hours per when the need for more care is limited and can be planned ahead. Once you are getting home health care, Medicare uses the following definition of part-time or intermittent to make decisions about your coverage: Skilled nursing or home health aide services combined must total less than 8 hours per day, and 28 or fewer hours each week.

Example: Fred has been getting home health care for 3 weeks. Fred's condition is improved, but his doctor would like Fred to continue to get home health care. Fred's doctor says that he needs a nurse to come in 3 days a week for 2 hours each day (a total of 6 hours) and a home health aide to come in 5 days a week for 3 hours each day (a total of 15 hours). This means that Fred is getting a total of 21 hours of home care per week, which meets Medicare's definition of "part-time or intermittent" home health care.

Medicare pays your home health agency a set amount of money for each 60 days you need care. (This 60-day period is called an "episode of care.") The payment is based on the kind of health care an average person in your situation would need. Medicare has paid hospitals this way for many years.

FAQ_Category: 
Home Health
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