Paying for home health services

If your doctor orders home health services for you or your loved one, you may wonder about the cost of care. Aurora Health at Home is here to answer any questions you have about insurance coverage, qualifying for home health services and payment options.

Medicare coverage for home health services

Medicare’s Home Health Benefit covers certain services that are intermittent (part-time) and needed for medical reasons. Home health aide services only qualify if they are a necessary addition to covered medical service. To receive home health services through Medicare, you must meet these requirements:

• You’re enrolled in Part A and/or Part B of the Medicare program.
• You’re homebound. Learn more about this designation and find answers to frequently asked questions about getting started with Aurora Health at Home.
• The home health agency providing your care has an agreement to participate in the Medicare program (Aurora Health at Home is an approved participant).

Medicare coverage for durable medical equipment (DME)

Medicare covers DME (including respiratory aids, infusion pumps and infusion supplies) through Medicare Part B. To ensure coverage for DME, your doctor and DME supplier must both accept Medicare. Aurora Health at Home participates in Medicare.

Medicare coverage for hospice care

Medicare covers all hospice services if you meet its requirements. You need to be:

• Enrolled in Medicare Part A
• Terminally ill, with a life expectancy of 6 months or less
• No longer seeking curative care
• Choosing hospice care instead of other Medicare-covered benefits to treat a terminal illness or condition

What you can expect to pay with Medicare

If you are enrolled in original Medicare, which includes Part A and Part B, you can expect to pay:

• Home health services: $0
• Durable medical equipment: 20% of the Medicare-approved amount + your Part B deductible
• Hospice: $0 for hospice care + $5 copayment for prescription drugs + 5% of the Medicare-approved amount for inpatient respite care (when applicable)

If you are enrolled in Medicare Advantage, your coverage and cost may vary. Check with your plan.

Medicaid coverage for home health services

If you’re eligible for skilled nursing services, Medicaid (Title 19), covers your home health services. In Wisconsin, Medicaid also covers:

• DME, including respiratory equipment
• Home and community-based care for certain people with chronic impairments
• Hospice care
• Rehabilitation and physical therapy

What you can expect to pay with Medicaid

Depending on your income, you could have to pay up to 20% of the cost of care.

Home health services coverage through private insurance

Coverage of home health services varies between private insurance plans. Many insurers follow Medicare guidelines, but check with your specific insurance plan. Private insurance plans, including Medicare Advantage plans, may require a copay and limit the number of visits you receive.

Making a payment

At Aurora Health Care, we’re here to help. For qualified patients, we offer our own financial assistance as well as access to state and national assistance programs and benefits.

Aurora Health at Home

You can pay for Aurora Health at Home services and hospice care right from your LiveWell account.

Home medical equipment

If you use home medical equipment, there are two ways to pay:

• You can make a payment through the Aurora Health at Home patient portal for current services received since January 2023.
• For services received prior to January 2023, you can make a payment here.

Infusion therapy

If you receive infusion therapy, you can make an online payment based on date of service:

• You can make a payment through the Aurora Health at Home patient portal for current services received since May 2022.
• For services prior to May 2022, you can pay your bill here.

Learn more about financial assistance at Aurora Health Care.

Making a difference

If you’d like to help support our patients enrolled in Aurora Health at Home, we’re always looking for gifts of time and funding.

You can make a difference for those in end-of-life transition by becoming a hospice volunteer. Or consider making a donation to support the Aurora Health at Home program.