Dear Marci,
I learned that Medicare may cover home health care for people who are homebound. How do I know if I am considered homebound?
-Alejandro (Madison, WI)
Dear Alejandro,
That’s a great question. As you said, Medicare covers home health care if you qualify. One of the requirements to qualify is that you be homebound. But what exactly does this mean?
Medicare considers you homebound if both of the following apply to you:
You need the help of another person or medical equipment to leave your home. For example, you need crutches, a walker, or a wheelchair to leave your home. Or, your doctor believes that your health or illness could get worse if you leave your home
And, it is difficult for you to leave your home and you typically cannot do so
Your doctor should decide if you are homebound based on their evaluation of your condition. If you qualify for Medicare’s home health benefit, your plan of care will also certify that you are homebound. After you start receiving home health care, your doctor is required to evaluate and recertify your plan of care every 60 days.
Even if you are homebound, you can still leave your home for medical treatment, religious services, or to attend a licensed or accredited adult day care center, without putting your homebound status at risk. Leaving home for short periods of time or for special non-medical events, such as a family reunion, funeral, or graduation, should also not affect your homebound status. You may also take occasional trips to the barber or beauty parlor.
I hope this helps as you and your doctor consider your needs for home health!
-Marci