Medicare may help pay for certain home-health services, but it usually will not pay for someone to stay with your husband for several hours each day simply to supervise him, provide companionship, or give you a break.

Under Original Medicare, your husband generally must be considered **homebound** and need part-time skilled nursing, physical therapy, or speech-language therapy ordered and certified by a qualified healthcare provider. If he qualifies for those skilled services, Medicare may also cover a home-health aide for limited personal care such as bathing, dressing, or toileting. However, Medicare normally will not cover a home-health aide when personal care or supervision is the only service needed.

Medicare describes covered home-health care as part-time or intermittent. Although its rules may allow skilled nursing and home-health aide services for a combined total of up to eight hours a day and generally no more than 28 hours a week, this does not mean Medicare will automatically provide someone to sit with him for those hours. The approved visits must be medically necessary and part of a Medicare-certified home-health plan. [Medicare home-health coverage](https://www.medicare.gov/coverage/home-health-s...)

I would begin by asking his doctor to order a home-health evaluation. Explain exactly what your husband cannot do safely by himself, such as walking, transferring, bathing, dressing, taking medications, or using the bathroom. Also explain his fall risk and why he cannot safely be left alone.

If he has a Medicare Advantage plan, call the member-services number on his insurance card. Some plans offer additional in-home support or caregiver benefits that Original Medicare does not provide. Ask specifically about:

* Home-health aide coverage
* Personal-care or attendant services
* Respite care for caregivers
* Adult day programs
* Transportation and meal benefits
* A case manager or social worker

If Medicare will not cover the help you need, Medicaid may offer personal-care attendants or home- and community-based services for people who qualify financially and medically. Veterans may have additional benefits through the VA. You can also contact your local Area Agency on Aging through the Eldercare Locator at **1-800-677-1116** and ask about respite care, personal-care programs, and caregiver assistance in your community.

You may also call **1-800-MEDICARE (1-800-633-4227)** and describe your husband’s needs. Ask them to explain what his coverage permits and how to locate a Medicare-certified home-health agency.

The short answer is that Medicare may cover limited home-health aide care when your husband also qualifies for skilled home-health services, but it generally does not cover a daily companion or sitter by itself. His doctor, insurance plan, and a home-health or social-work evaluation can help determine what assistance he may qualify to receive.

Home health services

https://www.medicare.gov/coverage/home-health-services

This last year I have also had difficulty swallowing At first it was dry foods like crackers but it progressed until I was concerned about eating solid foods. I mentioned it to my CPC and he referred me to a surgeon who could perform an endoscopyy to see if there was a physical blockage. After a consult the surgeon he did not think that was likely. I've had several surgeries in the last couple of years and because of my age (77) and the PD they don't want to administer sedation unless absolutely necessary.. He told me to come back if it got worse and he would re evaluate. Next, I was at a routine check with my neurologist and mentioned it to her. She set me up with a speech therapist and that was exactly what I needed

I gave all this background so that if anyone was experiencing swallowing problems you will know what worked for me and what did not.

Medicare paid for the speech therapist. It needs to be a referral documenting that you needed this specialistwere seeing this professional out of medical necessity. Any of your doctors can make the referral.

These therapists can do so much more than work on your speech They are trained to work on any problems concerning your throat,
And yes, just like any physical therapy, you have exercises to do.

That was several months ago and now it's seldom that I I cough or gag. Probably no more than anyone else. I do a series of exercises daily.

I know how frightening it is, especially at night, lying in bed and thinking you can't swallow your saliva. It's a lonesome place to be and you think nothing can be done. I wanted to share my experience to let you know that you're not alone and there is help available