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The Medicare HouseCalls Program is a service offered by UnitedHealthcare that allows you to have your annual wellness visit at home. Similar programs exist with other Medicare Advantage providers.
Usually, Medicare will cover limited in-home services for people who are homebound.
Your Medicare Advantage plan may include transportation and telehealth benefits to make getting to the doctor a bit easier.
Home Health Care through Medicare probably sounds appealing if you’re homebound or live in a remote area. You may have spotted ads for a Medicare Advantage HouseCalls program, bringing to mind images of old-timey doctors with stethoscopes around their necks and carpet bags full of medical supplies while making a home visit. Unfortunately, getting Medicare house calls isn’t quite as straightforward as it might seem. While services like the UnitedHealthcare HouseCalls program can make home health services more accessible, they won’t cover all home health services, and you will need to meet specific eligibility requirements for what they do provide.
The UnitedHealthcare HouseCalls programdoes not provide all-inclusive at-home health care services (it may not cover physical therapy, for example). Instead, it simply allows you to get your primary care annual wellness check-up at home during a home visit, rather than having to make the trip to a nursing facility or hospital for in-person therapy services. This isn’t a service exclusive to UHC either: many providers, Medicare Advantage or otherwise, dispatch nurse practitioners to a client’s home for a basic check-up. This isn’t a universal benefit, however, so check with your provider to see if this is something your plan offers.
During an at-home wellness check or home visit, your nurse practitioner will do all the things typically done during a regular check-up, like take blood pressure, take your vitals, and ask you questions about your current health and habits. Unfortunately, this service isn’t intended to provide more intensive care. However, that doesn’t mean home health care services aren’t available.
As a rule of thumb, Medicare will only cover home health services for people who are homebound. This means that you have difficulty leaving the home without assistance. Examples of situations where a person would be considered homebound include:
Regardless of the reason, Original Medicare (Medicare Part A and Medicare Part B) and Medicare Advantage (Medicare part C) offer limited in-home services.
These include:
Skilled nursing care, such as drawing blood, changing bandages, or other services a nurse would typically provide.
Physical and occupational therapy, and speech-language pathology services. These are especially common following strokes and similar conditions.
Medical social services.
Administration of osteoporosis drugs.
Medicare will not cover non-medical services, like cooking and laundry, (you’d need an independent home health agency for that) though they may provide intermittent home health aide care (bathing, dressing, feeding) as part of another covered service.
Medicare Advantage may offer additional services, such as meal delivery, or shopping assistance through a partnership with a service like Papa. However, full-time care and homemaking services simply are not covered by the majority of plans.
One exception to this rule is hospice: when you enter hospice, Medicare will cover all in-home palliative care. However, you cannot seek treatment for your illness during this time. You may elect to leave hospice at any time, especially if your condition appears to improve, but you will lose the in-home benefits while undergoing active treatment.
Fortunately, many Medicare Advantage plans have a home health agency available to help homebound seniors, even if the required services don’t always take place in the home.
Transportation Services: Medicare Advantage plans may partner with rideshare services like Uber Health, or contract a local medical shuttle or ambulette service, to help transport you to and from your medical appointments.
Telehealth: Telehealth services allow you to contact a doctor remotely, often using a dedicated app. Many basic medical services can be performed via telehealth, especially if direct contact is not required.
Other services may be available through your specific plan. If you’re curious about your options, call us today at (800) 950-0608 to speak with a licensed insurance agent, or enter your zip code into our free comparison tool to find plans in your area.
