RESOURCES

Home Health Agencies and Medicare

Resource1 Home Care Staffing

Home health agencies are an alternative to nursing home care and provide care in the home to people with medical conditions or disabilities. Services offered by home health agencies include skilled nursing care, physical therapy, speech therapy or home health aide services. Doctors can suggest whether it is suitable for the patient to receive care at home.

Medicare Coverage

There are instances when Medicare pays for care at home through a Medicare-certified home health agency. To qualify, the attending doctor must certify that all of the following are true:

  • You are a Medicare beneficiary under a doctor’s care.
  • You are homebound (unable to travel outside the home without assistance).
  • You need skilled nursing care (besides drawing blood) or physical, occupational, or speech therapy, according to Medicare restrictions and guidelines

The doctor must order these services for the patient. Be aware that the doctor might order different services, or more frequent services, than what Medicare pays for. Ask your provider whether you would need to pay out of pocket costs for any of the services the doctor wants you or the patient to have.

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