What Medicare covers at home
- Part-time or intermittent skilled nursing care, such as wound care, injections or monitoring a serious illness.
- Physical therapy, occupational therapy and speech-language pathology services.
- Home health aide visits, only while you also get skilled nursing or therapy.
- Medical social services, medical supplies, and durable medical equipment such as a walker or hospital bed.
You pay nothing for covered home health services. For durable medical equipment you usually pay 20% of the Medicare-approved amount after the Part B deductible. Medicare doesn't pay for 24-hour care, meal delivery, homemaker services, or personal care when that's the only care you need. Medicare Advantage plans cover home health too, usually through in-network agencies and often with prior approval.
What's different in Florida
- Extra billing review. Florida is one of the states in CMS's Review Choice Demonstration for Home Health Services, under which agencies' Original Medicare claims get extra review. It doesn't change what you're covered for.
- State licensing. The Agency for Health Care Administration (AHCA) licenses Florida home health agencies under Chapter 400, Part III, Florida Statutes.
- Hurricane planning. Florida law (s. 252.355) requires home health agencies to give their special-needs clients information on registering with the state's special needs registry for evacuations and shelters.
- Fraud. Miami was the site of the first federal Medicare Fraud Strike Force in 2007. Never sign blank forms or accept care you don't need, and read your Medicare Summary Notice. Report suspected fraud to 1-800-MEDICARE, HHS-OIG at 1-800-HHS-TIPS, or the Senior Medicare Patrol at 1-877-808-2468. See Medicare fraud in Florida.
When Medicare isn't enough: Florida Medicaid
If you have full Florida Medicaid, home health visits by a nurse or aide are a covered Medicaid service. For ongoing help with bathing, dressing, meals or housekeeping, Florida Medicaid's Long-Term Care program offers personal care, homemaker and other in-home services to people who need nursing-home level of care, but home and community-based services have a statewide wait list ranked by priority score. See Florida Medicaid long-term care.
To compare how plans from the companies they work with handle home health, you can request a call from a licensed insurance agent.
Related questions
Does Medicare cover nursing home care in Florida?
Skilled nursing stays and long-term care.
Does Medicare cover assisted living in Florida?
What pays for an ALF.
How do I get rides to the doctor with Medicare in Florida?
Ambulance, Medicaid rides and county programs.
Sources
- Medicare.gov — Home health services
- CMS — Review Choice Demonstration for Home Health Services
- Florida Statutes — s. 400.462, Home health agencies: definitions
- AHCA — Home Health Services (Florida Medicaid)
- AHCA — Find Out About Long-Term Care Services
- Florida Statutes — s. 252.355, Registry of persons with special needs
- HHS Office of Inspector General — Medicare Fraud Strike Force
More questions in this guide
- Does Medicare cover assisted living in Florida?
- Does Medicare cover me if I travel to Cuba, Latin America or the Caribbean?
- Does Medicare cover dental in Florida?
- Does Medicare cover nursing home care in Florida?
- How do I get rides to the doctor with Medicare in Florida?
Part of the guide: Medicare basics for Floridians · All questions
Frequently asked questions
What does homebound mean for Medicare?
Leaving home isn't recommended because of your condition, or you need help, a device such as a walker or wheelchair, or special transportation to leave, and leaving takes a lot of effort. You can still leave for medical care, adult day care, religious services or short, infrequent outings.
Does Medicare pay for a home health aide to help with bathing in Florida?
Only while you're also getting skilled nursing or therapy. Medicare doesn't pay for personal care when it's the only care you need. Florida Medicaid's Long-Term Care program can cover personal care at home for people who qualify, but it has a wait list.
How do I find a home health agency in Florida?
Your doctor should give you a list of agencies that serve your area. You can compare Medicare-certified agencies on Medicare's Care Compare and check a Florida agency's license on AHCA's FloridaHealthFinder site.
Medicare in your Florida county
Plans, local agents and help, county by county: Miami-Dade · Broward · Palm Beach · Hillsborough · Orange · Duval · Pinellas · Lee · Polk · Pasco · Brevard · Volusia · Seminole · Sarasota · Osceola · Manatee · Lake · Marion · Collier · St. Lucie · All 67 counties →
