Medicare Home Health Coverage
Ideal Choice Home Health is a Medicare-certified agency. We accept Original Medicare and also work with the VA and select Medicare Advantage plans on a case-by-case basis. Contact us to verify coverage.
- Your doctor orders careWe’ll help get the referral
- We check your coverageMedicare typically pays 100%
- Care starts at homeWe schedule your first visit quickly
Coverage questions shouldn't stand between you and care. Call us, and our intake team will help you and your physician understand your coverage before care begins.
Who Qualifies for Medicare Home Health
According to Medicare.gov, Original Medicare covers home health when:
- You are under the care of a doctor or allowed practitioner, and your care follows a plan of care that is regularly reviewed.
- A doctor or allowed practitioner certifies that you are homebound.
- You need part-time or intermittent skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy.
- Your care comes from a Medicare-certified home health agency.
What "homebound" means
Medicare considers you homebound when both of these are true:
- Leaving home isn't recommended because of your condition, or you have trouble leaving home without help, such as a cane, walker, wheelchair or crutches, special transportation, or help from another person, because of an illness or injury.
- You're normally unable to leave home, and leaving takes a lot of effort.
You can still leave home for medical treatment, short and infrequent outings such as religious services, and adult day care. (Source: Medicare.gov)
What You Pay With Original Medicare
With Original Medicare, you pay nothing for covered home health services, according to Medicare.gov. Durable medical equipment is billed separately: after you meet the Part B deductible, you pay 20% of the Medicare-approved amount.
If you have a Medicare Advantage plan, check with your plan, or call us and we'll help verify your benefits.
What Original Medicare Doesn't Cover
24-hour care at home, meal delivery, homemaker services, and custodial or personal care when it's the only care you need.
VA and Medicare Advantage Plans
We work with the VA and select Medicare Advantage plans on a case-by-case basis. Coverage and authorization requirements vary by plan, so please contact us to verify coverage before care begins.
Before Care Starts
Before care begins, we explain what Medicare covers. When required, we provide advance notice of services Medicare is not expected to cover, consistent with applicable Medicare notice requirements.
Does Medicare cover home health care?
Yes. Original Medicare covers home health for patients who are homebound, need skilled care, and have a physician's order.
Do I need a hospital stay first?
No. Medicare doesn't require a hospital stay before home health. A qualifying face-to-face encounter with an authorized practitioner is required. Certain telehealth encounters may qualify under applicable Medicare rules.
Is home health covered under Part A or Part B?
Both. Medicare covers home health under Part A and Part B for eligible patients, and our intake team confirms your eligibility.
How long can I receive home health?
It depends on medical necessity. Care is planned in 60-day periods based on your physician's orders, and your physician can recertify your plan of care if you still qualify and need skilled care.
Do you accept Medicare Advantage?
We work with select Medicare Advantage plans on a case-by-case basis. Call us with your plan information and we'll verify coverage.
Can I choose my home health agency?
Yes. You can choose any Medicare-certified agency that serves your area, and you can ask your doctor or discharge planner to refer you to Ideal Choice.
Check Your Coverage
Call (747) 877-8440, Monday through Friday, 10 AM to 5 PM. Please don't send insurance details or policy numbers through our website forms; our team will verify them by phone.