Does WellCare Cover Home Health Care?
- Some Wellcare Medicare Advantage plans can cover home health care, including things like skilled nursing care, home health aides or home delivery of meals and prescriptions. Learn about what other home health and caregiving services may be covered by some Wellcare Medicare plans.
A lot of older adults or their caregivers wonder if home health care is covered by Medicare or other insurance like a Wellcare Medicare Advantage plan.
“Home health care” is a broad term that encompasses a number of various services related to health care that is delivered in one’s home. Some of those may be covered, while others are not.
Original Medicare (Medicare Part A and Part B) requires a number of home health care services to be covered by all Medicare Advantage (Medicare Part C) plans, including those offered by Wellcare. In fact, some Wellcare Medicare Advantage plans may cover more home health care benefits than Original Medicare.
Let’s explore the home health care services that may be covered by a Wellcare Medicare Advantage plan.
Medicare Pays for Skilled Nursing Care, Therapy and More
Wellcare Medicare Advantage plans are required by law to provide coverage for everything covered by Original Medicare. Original Medicare benefits include coverage of a number of home health care services, all of which you’ll find in a Wellcare Medicare Advantage plan.
Intermittent skilled nursing care
Skilled nursing care includes administering injections and IV drugs, tube feedings, changing bandages and cleaning wounds, managing prescription medications and more.
Original Medicare covers intermittent skilled nursing care in the home when needed for fewer than 8 hours per day and 28 hours per week when certain other conditions are met. This means all Medicare Advantage plans – including those from Wellcare – must meet at least these basic coverage requirements for skilled nursing care.
Home health aides
When skilled nursing care is needed, Medicare can also cover the cost of personal care. Personal care, or non-skilled care, includes assistance with activities of daily living such as dressing, bathing and eating. Medicare does not cover personal care if it’s the only type of care needed.
Physical therapy
Outpatient physical therapy is covered by Medicare, and the coverage can extend to therapy received in your own home if you are deemed to be home-bound or have difficulty leaving your home to get to an outpatient facility.
Occupational therapy
Occupational therapy is a type of therapy designed to improve one’s ability to perform activities of daily living. It’s covered in the home as well as in outpatient or inpatient care situations.
Speech therapy
Speech therapy aims to strengthen, maintain or regain speech and language skills and can include cognitive and swallowing skills. Wellcare Medicare plans cover speech therapy in the home at least as well as Original Medicare covers it.
Social services
Covered social services can include counseling or assistance in finding community resources to keep social and emotional barriers from interfering with your treatment or recovery. Coverage is only available when skilled nursing care is being delivered.
Durable medical equipment
Durable medical equipment (DME) includes wheelchairs, walkers canes and other equipment and supplies that are designed primarily for use in the home.
What Does Wellcare Pay for Home Health Care?
Because Medicare Advantage plans are required to cover everything covered by Original Medicare, all Wellcare Medicare Advantage plans cover all of the home health care services listed above.
In addition, certain Wellcare Medicare Advantage plans may also cover some of the following home health care services. Please note Wellcare Medicare Advantage plans with the benefits listed below may not be available in all areas.
Home delivered meals
Some Wellcare Medicare Advantage plans may cover meals delivered to your home following an inpatient stay at a hospital or skilled nursing facility. Meals can also be covered for members with chronic conditions as part of a supervised lifestyle modification program.
Additional plan-approved grocery items may also be covered for Wellcare members who meet certain conditions.
Home delivery of medications and over-the-counter items
Medicare Advantage plans with prescription drug coverage can mail your medications straight to your home, saving you a trip to the pharmacy. Even over-the-counter health items like cold medicine can be covered and delivered to your home.
Members of certain Wellcare plans can purchase over-the-counter items from participating locations or through their plan’s catalog for home delivery.
Fitness and wellness programs
Some Wellcare Medicare Advantage plans include a membership to a health and fitness program like SilverSneakers, with an at-home fitness kit including exercises and activities that can be conducted at home.
24-hour nurse hotline
Wellcare Medicare Advantage plans can include access to a 24-hour nurse advice telephone line with no copayment required.
Telehealth
A Wellcare Medicare plan can allow you to conduct virtual visits with your doctor from the comfort of your own home using a computer, tablet or smartphone with internet and camera capabilities.
Utility flex card
Certain Wellcare plans include a Wellcare Spendables Medicare flex card that can be used by qualifying members of certain types of Wellcare D-SNP (Dual Special Needs plans) to pay for things like qualifying home utility bills, over-the-counter (OTC) items, healthy food, rent or fuel at gas stations.
Helpadvisor.com is owned and operated by Tranzact, the parent company of TZ Insurance Solutions LLC, which is the owner/operator of MedicareAdvantage.com and other websites mentioned on HelpAdvisor and which has a financial relationship with some of the carriers listed on HelpAdvisor.
