Medicare covers many healthcare services that you can receive in the comfort and privacy of your home. These include intermittent skilled nursing care, physical therapy, speech-language pathology services and occupational therapy.

Such services used to be available only at a hospital or a doctor’s office. But they’re just as effective, more convenient and usually less expensive when you get them in your home.

If you get your Medicare benefi ts through a Medicare Advantage health plan instead of original Medicare, check for details about how the plan provides your Medicare covered home health benefits.

To be eligible for home health services, you must be under a doctor’s care and receive your services under a plan of care established and reviewed regularly by a physician, who also needs to certify you need one or more home health services.

In addition, you must be homebound and have a doctor’s certifi- cation to that effect. Being homebound means leaving your home isn’t recommended because of your condition or your condition keeps you from leaving without using a wheelchair or walker or getting help from another person.

Also, you must get your services from a home health agency that is Medicare-approved.

Skilled nursing services are covered when they’re given on a part-time or intermittent basis. In order for Medicare to cover such care, it must be necessary and ordered by your doctor for your specific condition. You must not need full-time nursing care.

Skilled nursing services are given by a registered nurse or a licensed practical nurse under a registered nurse’s supervision. Nurses provide direct care and teach you and your caregivers about your care. Examples of skilled nursing care include changing dressings, teaching about prescription drugs or diabetes care, and giving IV drugs, shots or tube feedings.

Any service that could be done safely by a nonmedical person or by yourself, without nurse supervision, isn’t skilled nursing care.

Physical therapy, occupational therapy, and speech-language pathology services have to be specific, safe and effective treatments for your condition.

Before your home healthcare begins, the home health agency should tell you how much of your bill Medicare will pay. The agency should also tell you if any items or services they give you aren’t covered by Medicare and how much you’ll have to pay for them. This should be explained both by talking with you and in writing.

The agency should give you a notice called the Home Health Advance Beneficiary Notice (HHABN) before giving you services and supplies that Medicare doesn’t cover.

What isn’t covered? Some examples:

•24-hour-a-day care at home.

•Meals delivered to your home.

• Homemaker services like shopping, cleaning and laundry when these services aren’t related to your plan of care.

•Personal care given by home health aides like bathing, dressing and using the bathroom when this is the only care you need.

If your doctor decides you need home healthcare, you can choose from among the Medicare-certified agencies in your area. However, Medicare Advantage plans may require that you get home health services only from agencies they contract with.

A good way to look for a home health agency is by using Medicare’s Home Health Compare web tool at www.medicare.gov/ HHCompare. You can compare home health agencies by the types of services they offer and the quality of care they provide. For more details, read the booklet “Medicare and Home Health Care,” available at www.medicare.gov/publications.

David Sayen is Medicare’s regional administrator for California, Arizona, Nevada, Hawaii and the Pacific Trust Territories.