Medicare was established in 1965 for people aged 65 or older. It now also covers people of any age with permanent kidney failure or certain disabilities. Medicare currently covers over 40 million people. Medicare pays for 28.4% of all home care. Medicare has two parts: Hospital Insurance (Part A), and Medical Insurance (Part B). Part A helps pay for care in a hospital or skilled nursing facility or for care from a home health agency or hospice. Part B helps pay for physician services and various other medical services and equipment. Medicare will only pay for care it determines to be medically necessary. Medicaid, which pays for 18.5% of all home care, is a medical assistance program for low-income people.
Medicare pays for intermittent, not continuous, services provided by a certified home health agency. The agency must meet specific guidelines established by Medicare. To qualify for home health care, Medicare recipients must be unable to leave home, and their doctors must determine that they need home health care. Medicare will pay the full cost of most covered home healthcare services. However, Medicare will not pay for round-the-clock home health care. Home health care plays an important role when skilled care is needed on a part-time basis.