Contrary to regular misunderstanding and misstatements, Medicare coverage is available for home health coverage with no duration of time limit. In fact, Medicare home health coverage is available under the law “so long as skilled care is received” (Medicare Home Health Benefit Policy Manual, Chapter 7, Section 40.1.1) for people who meet basic qualifying criteria: “homebound” and need skilled nursing and/or therapies.
The key question to ask is: Does the person need and receive skilled care? Skilled means a qualified professional is needed to ensure the care is safe and effective. Skilled care can be covered to provide or supervise care for people with on-going conditions, to maintain or slow decline. Improvement potential is not required.
“Even if full recovery is not possible, a patient may need skilled services to prevent further deterioration or preserve current capabilities.” (42 CFR Section 409.32, 409.33; Important Message About Jimmo, CMS.gov).
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