Medicare Coverage for Your Home Health Services

Visiting Nurse Association is a Medicare certified home health agency.

Medicare is a national health insurance program provided by the federal government. It covers people age 65 or older and people of all ages with certain disabilities or end-stage renal disease. To receive Medicare coverage for home health, you must meet all four of the following criteria:

• A doctor must determine that medical care in your home is necessary and make a home health care plan for you accordingly.
• You must also need at least one of the following services:
  • Intermittent (part-time) skilled nursing care
  • Physical or speech therapy
  • Continued occupational therapy
• You must also be homebound.
• The home health agency caring for you must also be approved by the Medicare program. Approved agencies like Visiting Nurse Association are typically referred to as “Medicare certified agencies.”

If you or your loved one receive Medicare benefits and meet all four criteria, Medicare will cover:

• Skilled nursing on a part-time basis, as long as your home health care provider is a registered or licensed practical nurse.
• Rehabilitation therapy, if ordered by your doctor.
• Home health aide services on a part-time basis. Medicare will only cover home health aide services if you are also getting skilled care like nursing or other therapy.
• Medical social work services to assist with social and emotional concerns related to your illness, injury or condition.
• Certain medical supplies, such as wound dressings.

Medicare does not pay for:

• 24-hour per day care in the home
• Meals delivered to the home
• Homemaker services (such as cleaning, laundry, shopping, etc.)

If you need home health care, our billing specialists can assist with determining Medicare coverage for your individual needs. Please call 816-627-6210.

To learn more about Medicare in general, call 1-800-MEDICARE or visit medicare.gov.

Eligibility criteria for many private insurance plans are similar to Medicare guidelines. Our billing specialists will be happy to contact your private insurance carrier for individual eligibility requirements.