Does Medicare Pay for Family Caregivers?

Will Medicare Cover Family Caregivers?

If you develop a medical condition that requires frequent or constant at-home healthcare, this can be time consuming and expensive. Often, the responsibility of becoming a caregiver for a mother, father, or parent can fall to an adult child, leaving many to wonder “does Medicare pay for family members to be a caregiver?”

Unfortunately, Medicare is not responsible for covering the expenses of medical or custodial care provided by family members. However, on occasion, Original Medicare (Parts A and B) may cover at-home healthcare provided by skilled nursing professionals.

Exactly what type of care is covered in this scenario depends on a number of factors. Let’s discuss some of them together.

Does Medicare Cover Caregivers?

If you are wondering, “how do I get Medicare to pay for a caregiver?” here is the answer: For the most part, whether Medicare will cover in-home caregivers depends on exactly what type of care one is receiving. Keep in mind that to remain eligible for Medicare at-home medical care coverage, you will need to see your doctor fewer than 90 days before, or 30 days after, you begin to receive home healthcare services. 

In the following scenarios, Medicare benefits may apply:

In-Home Medical Care

In-home medical care is defined as any professional-grade medical care that one receives at home as a result of doctor’s orders. Typically, services and treatments of this variety that are covered by Medicare include:

• Skilled nursing care that occurs for less than eight hours per day and no more than 28 hours per week, for up to three weeks.
• Catheter change
• Wound dressing change
• IV and Injection-based medication
• Tube feeding (if applicable)
• Vital sign monitoring
• Nutrition
• Medical and self-care education

Physical Therapy

If a qualified, Medicare-approved physical therapist provides you with in-home treatment, Medicare may cover the following services:

• Condition assessment
• Gait training and related exercises designed for recovery from surgery, illness, or neurological conditions like stroke
• Post-operative wound care
• Wound care for injuries, lesions, or burns

Occupational Therapy

If a qualified, Medicare-approved occupational therapist treats you at home, the following services are likely to be covered under Medicare:

• Daily medication routine establishment and maintenance
• Energy conservation and stress reduction strategies
• Education on the safe practice of daily activities
• Assistance adhering to doctor orders

Speech Therapy

If a qualified, Medicare-approved speech therapist provides you with in-home treatment, Medicare may pay for the following:

• Word recognition and memory
• Therapy targeted at basic function, including eating, drinking, and swallowing
• Alternative communication education if you’ve lost the ability to hear or speak

What Are Some Other Professional Caregiver Services That May Be Covered Under Medicare?

Medicare does not typically cover caregivers who are solely responsible for custodial care needs, such as dressing, personal hygiene, restroom assistance, meal prep and delivery, and daily living, unless these services are provided short-term and by professionals approved by Medicare.

Typically, Medicare will not pay for 24-hour in-home care, full-time skilled nursing care, or transportation, unless these services are covered under your specific Medicare Advantage plan. If you have additional questions or concerns about assistance for caregivers under Medicare, click here for additional information and resources.

For professional assistance with researching and comparing Medicare Advantage plans in your area, reach out to MedicareInsurance.com today via our online chat feature, or by phone at (800) 950-0608. Our friendly and professional agents are fully licensed and are ready and willing to help.