What Services Does Medicare Cover in South Florida?

South Florida’s golden years can be filled with beachside strolls in Fort Lauderdale, cultural gems in Miami, and serene sunsets in Palm Beach—but health challenges shouldn’t dim that sparkle. For many seniors in Broward, Miami-Dade, and Palm Beach counties, Medicare is a cornerstone of coverage, particularly for home-based care that keeps you independent. At Home Healthy, we help navigate these benefits to pair them seamlessly with our compassionate services. Wondering what services does Medicare cover in South Florida? Let’s break it down, focusing on home health options that align with the region’s vibrant senior community. 

Understanding Medicare Coverage Basics in South Florida 

Medicare, through Parts A (Hospital Insurance) and B (Medical Insurance), covers eligible home health services for part-time or intermittent skilled care when you’re “homebound”—meaning leaving home requires considerable effort or assistance due to illness or injury. This is especially relevant in South Florida, where humid weather and urban sprawl can make outings tougher. Services must be ordered by a doctor after a face-to-face exam and delivered by a Medicare-certified agency. 

A unique note for South Florida: As part of Florida, you’re under a Medicare demonstration program (also in IL, OH, NC, TX). Agencies can request pre-claim reviews for faster coverage decisions without delaying care—ensuring quicker access amid our busy hurricane season or post-surgery recoveries. No copays for approved home health, but you’ll pay 20% for durable medical equipment after your Part B deductible. 

Key Medicare-Covered Home Health Services 

Medicare doesn’t cover 24/7 custodial care or homemaking alone, but it shines for skilled needs. Here’s what’s typically included, up to 8 hours/day or 28 hours/week (up to 35 in short-term cases): 

Skilled Nursing Care 

Part-time or intermittent visits for wound care (e.g., pressure sores), injections, IV therapy, or monitoring unstable conditions like diabetes—common in our tropical climate. Includes patient education on managing meds or self-care. 

Physical, Occupational, and Speech Therapy 

Hands-on rehab to regain mobility after a stroke or hip replacement, or improve daily functions. Speech therapy aids swallowing issues or communication post-illness, vital for South Florida’s multilingual seniors. 

Home Health Aide Services 

Limited to personal care like bathing, dressing, or grooming—but only alongside skilled nursing or therapy. No standalone help for meals or chores; that’s where non-Medicare options like Home Healthy fill the gap. 

Medical Social Services 

Counseling on emotional needs, accessing community resources (e.g., Palm Beach County Aging Services), or coordinating care—helping with the isolation that can creep in during our rainy seasons. 

Durable Medical Equipment and Supplies 

100% coverage for items like walkers, wheelchairs, oxygen, or wound dressings when prescribed. Medicare pays 80% for rentals/purchases after deductible. 

These align with Florida’s AHCA standards, promoting better outcomes and fewer hospital trips—key in areas like Miami with high senior density. 

Eligibility and Limitations for South Florida Seniors 

To qualify: 

• Be homebound (occasional outings for medical or short errands OK). 

• Need skilled care intermittently. 

• Have a doctor’s plan reviewed every 60 days. 

Medicare skips full-time care, meal delivery, or private-duty nursing beyond limits. For long-term non-medical needs, consider Medicaid (for low-income) or supplements like Medigap. South Florida’s SHINE program offers free counseling—call 1-800-963-5337. 

How Home Healthy Complements Medicare in South Florida 

Medicare gets you started, but for ongoing support—like companionship or errands in Boca Raton traffic—we step in affordably. Our certified team bridges gaps, ensuring seamless transitions. “Medicare covered the therapy, but Home Healthy made daily life joyful again,” shares a client from Hollywood. 

Curious about what services does Medicare cover in South Florida for your situation? Contact Home Healthy for a free assessment—we’ll review your benefits and craft a hybrid plan. Stay home, stay healthy, stay you. 

Home Healthy: Maximizing Medicare, Enhancing Lives.