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Who is Eligible

Medicare eligibility for Home Health

Home Health services must be ordered by a physician
The service must be reasonable and necessary in the treatment of the illness or injury
The patient must require a qualifying skilled intermittent service such as nursing care, physical therapy, occupational therapy, or speech therapy. Medical social services and home health aide services are covered only if the patient is receiving skilled nursing care, or physical or speech therapy.
The patient must be homebound*
The patient is an eligible Medicare beneficiary

When all of the above conditions and criteria are met, Medicare will reimburse for an unlimited number of visits.

*Homebound
Inability to leave home without considerable and taxing effort
Physician certifies homebound status
Patient with psychiatric condition who is considered unsafe to leave home unattended
Need for supportive devices in conjunction with physical limitations considered
Homebound patient is allowed brief and infrequent absences from home for non-medical reasons

Homebound status not met when:
Patient is able to drive a car safely
Patient has frequent absences from home for social reasons

 

 
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