In-home health care refers to a wide range of health care services that can be given in your home. These services can be provided for many types of illnesses or injuries. Many in-home health care costs are covered under Medicare. However, the costs and eligibility for medical equipment and services vary, depending on the reason for the in-home care.

Medical Equipment

If a Home Health Care patient needs medical equipment, it must be ordered by their doctor. If the equipment order is approved by Medicare, then Medicare will cover 80% of the cost. Unfortunately, not all orders will be approved by Medicare as they may not feel the equipment is necessary.

If a Hospice patient needs medical equipment, it is much easier to order.

Hospice nurses as well as doctors can order just about any kind of medical equipment. The equipment can be delivered to the patient’s home if the nurse or doctor certifies that it is needed for delivery of palliative care for the patient’s terminal condition. Best of all, the cost is covered 100%.

Medicare rarely argues with these decisions. If they do, Hospice staff can typically get such issues resolved quickly.

Personal Care Services

Another important difference between regular in-home health care and hospice care is that Medicare will not pay for personal care services under Home Health Care. These include things such as assistance bathing, going to the toilet, brushing teeth, or nail care.

However, a patient receiving Hospice care at home receives any personal care services they need that relates to palliative care for their terminal condition. Medicare covers the cost 100%.

Palliative care is not limited to drugs that relieve pain – it covers whatever the Hospice nurse or doctor says is needed. Medicare almost never argues about whether such services are needed for hospice patients.

Types of Equipment Covered by Medicare for Hospice Patients

Equipment commonly needed by Hospice patients, ordered by Hospice staff, and paid for 100% by Medicare includes:

·         Hospital beds with all necessary features

·         A high-quality pressure-relief mattress

·         Wheelchair and other specialty mobility devices

·         Trapeze bar and patient lift

·         Emergency communication devices

·         Patient monitors

·         Walker, four-footed cane, tub seat and bedside commode

·         Nebulizers

·         Oxygen and delivery devices

·         CPAP and BiPAP

·         High-flow therapy

·         Suction equipment

·         Feeding pump

Using VA Grants Wisely

Sometimes in-home health patients need alterations made to their home to help accommodate a disability. This is one thing that Hospice care does not typically cover.

However, a Veteran with a service-connected disability may be eligible for one of three types of grants from the VA. These grants can be used for modifications to their home, or to the home of a family member who is caring for them.

It is a good idea to investigate getting the appropriate VA grant BEFORE a Veteran becomes eligible for Hospice care if there is a chance that Hospice care will be needed in the future. Having the home specially fitted for disability mobility can make life easier for a Veteran and their caregivers long before a terminal illness requiring hospice care develops - if it ever does. Once a patient does require in-home Hospice care, these types of accommodations will be very helpful.

The three programs, each with its own requirements and benefits, are:

1. Specially Adapted Housing (SAH) grants

2. Special Home Adaptation (SHA) grants

3. Home Improvement and Structural Alteration (HISA) grants

In-Home Hospice care can be greatly facilitated if alterations to the veteran’s home are made prior to their need for Hospice care, which does not pay for such alterations.