What conditions must be met before Medicare pays for home health care?
Understanding Medicare home health care eligibility can help patients and families know when skilled care at home may be covered. Medicare covers certain home health services when specific requirements are met. Medicare
1. You Must Need Skilled Care
A patient must need part-time or intermittent skilled nursing care, physical therapy, speech-language pathology services, or meet Medicare's requirements for continued occupational therapy. The services must be reasonable and necessary for the patient's condition. Centers for Medicare & Medicaid Services
2. You Must Be Homebound
For Medicare-covered home health care, the patient must generally be considered homebound. This can mean needing another person's help, special transportation, or an assistive device such as a walker or wheelchair to leave home. The patient must normally be unable to leave home easily, and leaving must require considerable effort. Medicare
3. A Provider Must Order Home Health Care
A doctor or other allowed healthcare provider must evaluate the patient, certify the need for home health services, and order the care. The patient must receive services under an established and regularly reviewed home health plan of care. Centers for Medicare & Medicaid Services
4. Care Must Come From a Medicare-Certified Agency
For Original Medicare coverage, home health services must be provided by a Medicare-certified home health agency. Medicare
How OCTIHEALTH Can Help
OCTIHEALTH provides Skilled Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Home Health Aides, and Medical Social Work for eligible patients. Our team can help patients and families understand the home health process and coordinate care based on individual needs.
📲 Call or text OCTIHEALTH at (847) 305-3070 to learn more about home health services and eligibility.
