Medicare Information

Medicare is a federally funded health insurance program for U.S. residents over age 65. Coverage has two parts:

• Part A pays for inpatient hospital stays, care in a skilled nursing facility, and hospice and home care.
  
• Part B is the medical insurance portion that helps pay for physician visits, outpatient services, various supplies, therapy and other home care services that are not covered by Part A.
  
  

Patients must enroll in Part B and pay a monthly premium and a deductible. After the deductible is met, Medicare will pay 80 percent of the remaining cost.

Medicare covers the following Meridian At Home services:  

• Skilled nursing on a documented intermittent and part-time basis based on specific guidelines
  
• Home health aide on a part-time basis for bathing and dressing, as long as the patient is receiving skilled services from a registered nurse
  
• Physical, speech, and occupational therapy
  
• 80 percent of durable medical equipment, including wheelchairs and walkers
  
• Other medical equipment, including supplies for dressing changes
  
• Hospice services for patients who are terminally ill and have a life expectancy of six months or less provided there is a physician's certificate of need. Once hospice services are approved, other Medicare benefits related to the terminal illness no longer apply.
  

Medicare does not cover 24-hour care at home, prescription drugs, or homemakers/companions. 

Meridian At Home can bill Medicare for part-time skilled services when the following three criteria apply:

• The patient is under the care of a physician who decides that home-based skilled services are a medical necessity, and the physician creates a care plan that includes treatment goals.
  
• The patient requires part-time care from a skilled professional, such as a registered nurse, physical therapist, or speech therapist. There are limits on the number of hours and days a patient is covered for skilled care.
  
• The patient is homebound, meaning it takes a taxing effort to leave the home without the assistance of another person, with or without an assistive device.
  

We Can Help

Meridian At Home will bill Medicare for all covered services and let you know whether any services are not covered. If you have a Medicare-managed health plan, we will obtain prior authorization and inform you of any services that are not covered. In addition, we can help arrange for hospice coverage and care when necessary. Contact us for more information.