Home Health Eligibility Requirements
If you have Medicare, Medicaid, or a Medicare Advantage plan, you may be eligible for home health benefits if the following conditions are met:
- Your doctor must write an order stating that you need home health services.
- You must have a need for one of the following services: specialized nursing services, physical therapy, occupational therapy, or speech-language pathology services.
- You must be homebound, meaning you are not able to leave home without a considerable or taxing effort.
- Your medical need must be considered intermittent, meaning that you do not require full-time medical care that would be more appropriately provided by the hospital or a skilled nursing facility.
- The patient and/or primary caregiver must be willing to cooperate and comply with home health care services and be a willing and active participant in the plan of care.
Anyone can refer you to home health including you, a friend, a family member, or your doctor. As soon as eligibility is verified by all parties, one of our professionals will come to your residence to conduct the evaluation and admission.
For further information about Medicare coverage of home health benefits and eligibility requirements, please see the Medicare and Home Health Care web page.
How is the Care Paid For?
- Medicare Home Health Benefit: Medicare provides beneficiaries with a home health benefit that covers 100% of services. Medicare beneficiaries use Medicare Part A or Part B for home health services.
- Private insurance companies offer similar home health benefits. A small co-payment for services may be required depending on the insurance provider. Upon referral, our Admissions Team will verify insurance benefits to determine what is covered. Click here for a list of insurance companies First Choice accepts.