Qualifying For Services

Types Of Services

Research has shown that people heal faster at home if supported by appropriate health services.

For Medicare beneficiaries and for certain insurance plans, patients must be homebound to qualify for home care services. This means that because of a physical condition or limitation, the patient cannot leave home without extreme difficulty or assist of others. Homebound status is not affected by absences from home for doctor's visits or medical treatment such as dialysis or chemotherapy. The absence of transportation does not render a patient homebound.

A patient must be under the care of a physician and must require the services of a skilled nurse or physical therapist. All services provided must be discussed and ordered by a physician.. Home health service is designed to meet the goals determined by the nurse and /or therapist on the treatment plan within a defined time period. Home health service is not “round-the-clock” care, but is a specialized treatment plan of skilled care visits by a team that teaches, gives treatments and helps a patient and family through an illness episode toward optimal independence.

Home Care visits for Medicare or Medicare Advantage beneficiaries are covered under the following conditions:

They have a need for skilled care.
They are confined to the home, considered homebound.
They have an order from a physician.

For those with a private insurance policy or some managed care plan, HomeCare visits are covered under the following conditions:

They meet the plan’s conditions of participation.
They have an order from a physician.