Care under Medicare?

Many health care treatments that used to be done only in a hospital can now be done in your home. Health care given in the home is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility. If you are eligible, Medicare pays for you to get certain health care services in your home. This is known as the Medicare home health benefit. If you get your Medicare benefits through a Medicare Health Plan, other than the Original Medicare Plan, check your plan’s membership materials and call the plan for details about how the plan provides your Medicare-covered home health benefits.

FAQs about Medicare

1. To qualify fo Medicare coverage, is there a certain criteria a patient must meet?
2. If the patient is 65 or older and still working, will Medicare pay for home health services?
3. Are home visits covered under Medicare?
4. Do patients have to pay The Aspen Group for services?
5. Do patients decide whether to use Part A or Part B of Medicare?
6. Does Medicare cover outpatient Physical Therapy?
7. Does Medicare pay for Hospice services?
8. Are services for mental illness covered?

To qualify fo Medicare coverage, is there a certain criteria a patient must meet?

The patient must be 65 years old or older
The patient currently receives Social Security benefits or is enrolled in the railroad retirement system
The patient is younger than 65-years-old and has received Social Security disability benefits for at least two years (24 months)
The patient suffers from permanent kidney failure

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If the patient is 65 or older and still working, will Medicare pay for home health services?

Yes. A patient can use Medicare. However, if a patient is covered by an employer's insurance plan, the employer's health insurance could be used in conjunction with Medicare.

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Are home visits covered under Medicare?

Each of the following conditions must be met:

The patient's physician has requested home healthcare and established a plan of care.
The agency is Medicare-certified.
The patient cannot leave home without assistance.
The patient requires nursing care, physical therapy or speech therapy that is reasonable and necessary throughout the patient's episode of care.

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Do patients have to pay The Aspen Group for services?

No. The Aspen Group will bill Medicare directly. Medicare has two parts:

PART A — hospital insurance that is part of the patient's Social Security benefit
PART B — medical insurance the patient pays for monthly

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Do patients decide whether to use Part A or Part B of Medicare?

No. Part A and Part B will pay for covered home health-care services. The Aspen Group will inform the patients of their coverage.

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Does Medicare cover outpatient Physical Therapy?

Yes, if the physician refers the patient and the patient qualifies for outpatient therapy.

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Does Medicare pay for Hospice services?

Yes, if the patient qualifies for hospice services. For more information on hospice services, go to What is Hospice?

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Are services for mental illness covered?

Yes, if the patient qualifies for home healthcare under Medicare.

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Additional questions regarding coverage should be directed to your local Aspen Group office or the pamplet Medicare and Home Health distributed by the Center for Medicare and Medicaid Services.