Patients must be under the care of a doctor, or other allowed practitioner such as a Nurse Practitioner or Physician’s Assistant and getting services under a plan of care that is reviewed regularly by a doctor. A doctor must certify that the patient needs:
Intermittent skilled nursing care (other than drawing blood). And/or:
Physical, speech or occupational therapy services
The Centers for Medicare and Medicaid Services states that for a patient to be eligible to receive covered home health services, a physician must certify that the patient is confined to his or her home. An individual is considered “confined to the home” (homebound) if he or she:
Because of illness or injury, needs the aid of supportive devices such as crutches, canes, wheelchairs and walkers; the use of special transportation; or the assistance of another person in order to leave their place of residence
Have a condition such that leaving his or her home is medically contraindicated.
In addition, there must exist a normal inability to leave home, and leaving home must require a considerable and taxing effort.
Please note, an individual may still qualify for home health care if he or she leaves home for medical treatment or short, infrequent absences for non-medical reasons, such as attending religious services.
If you believe you or someone you know may qualify for home health services, please contact us at 217.462.0355
Cost
Home health care is a Medicare Part A benefit that does not require a copay or deductible for patients who meet eligibility criteria. Other payment sources may include Medicaid, private insurance, workers’ compensation, private payment or alternative funding.
