Caregiving Benefits Explained: A Comprehensive Look at Medicare Advantages
In the event of a heart attack, it's crucial to seek immediate help. Symptoms such as chest pain, nausea, shortness of breath, and lightheadedness could indicate a heart attack. Dial 911 or the number of the nearest emergency department without delay [1].
For those requiring long-term care, Medicare offers a range of home health services to support caregivers. These services include intermittent skilled nursing care, skilled therapy services (such as physical, occupational, and speech therapy), and care provided by home health aides to assist with activities of daily living (ADLs) like bathing and dressing [1].
Medicare also covers essential durable medical equipment (DME) such as wheelchairs, walkers, and other assistive devices needed during home health care, typically covering about 80% of the Medicare-approved cost [1]. Costs for home health services themselves are usually fully covered under original Medicare or Medicare Advantage, but beneficiaries may pay 20% for DME and a Part B deductible applies [1].
In some cases, Medicare may also cover custodial or non-skilled personal care, including help with daily tasks that do not require skilled nursing [1]. Additional relevant equipment Medicare covers includes airway clearance devices and mobility devices like manual and power wheelchairs with specialized features, provided specific medical criteria are met and prior authorization is obtained when required [3][5].
Some states offer home- and community-based services that can assist caregivers, including home health aides, personal care assistance, homemaker services, respite care to relieve caregivers, personal emergency response systems, and home modifications for safety and accessibility [4].
It's important to note that Medicare does not cover meal delivery services. However, some Medicare Advantage plans offer coverage for meal delivery services, which can ease a caregiver's burden [2].
Social workers, who are health professionals, help connect older adults to resources, provide counseling, and coordinate with family members on care plans. Their services are covered under Medicare Part B, with the person receiving services usually responsible for 20% of the cost [2].
Speech-language pathology services, which help with speech skills and swallowing, are also covered under Medicare Part B when they are medically necessary, with the person receiving services usually responsible for 20% of the cost [2].
Skilled nursing facilities provide in-patient care for people who need services like physical therapy or daily medications. Original Medicare pays for skilled nursing care after 3 days, while Medicare Advantage plans may begin paying sooner [2].
Caregivers may need to rent or buy the equipment, or they may have the option to choose between renting or buying. Medicare Part B covers durable medical equipment such as hospital beds, wheelchairs, and oxygen equipment for home use [2].
A study from 2015 to 2017 found that over 45-year-old adults reported being caregivers to loved ones in the last 30 days [6].
In an emergency, it's essential to remember that if someone stops breathing before first responders reach the scene, check for a pulse. If they have a pulse, provide rescue breathing at a rate of 1 breath every 6 seconds or 10 breaths per minute [1].
In summary, Medicare supports caregivers by covering skilled home health care and essential durable medical equipment, while additional supportive home services and adaptive equipment may be available through state programs or other waivers [1][3][4][5].
Key Medicare-covered home health services and equipment:
- Intermittent skilled nursing care
- Skilled therapies (physical, occupational, speech)
- Home health aide services (help with ADLs)
- Durable medical equipment (wheelchairs, walkers, etc.)
- Certain airway clearance devices and mobility aids (with criteria)
Additional caregiver supports (from related state programs):
- Respite care
- Homemaker services
- Personal emergency response systems
- Home modifications for safety and accessibility
This coverage applies for adults over 45 who qualify for Medicare home health benefits and meet clinical criteria for these services and equipment [1][3][4][5].
[1] Medicare.gov [2] MedlinePlus.gov [3] NCOA.org [4] AARP.org [5] MedicareInteractive.org [6] National Alliance for Caregiving and AARP Public Policy Institute
- For long-term care, Medicare offers home health services that support caregivers, including intermittent skilled nursing care, skilled therapy services, home health aide services, and durable medical equipment coverage.
- Some states offer additional supportive home services and adaptive equipment for caregivers, such as respite care, homemaker services, personal emergency response systems, and home modifications for safety and accessibility.
- Skilled nursing facilities provide in-patient care for those who need services like physical therapy or daily medications, and while Medicare Advantage plans may begin paying for skilled nursing care sooner, original Medicare usually pays after 3 days.
- Speech-language pathology services, which help with speech skills and swallowing, are also covered under Medicare Part B when they are medically necessary, with the person receiving services usually responsible for 20% of the cost.
