Medicare coverage for Home Health Services

To qualify for Medicare coverage, the patient must meet the following criteria:

  • The patient must be 65 years old or older.
  • The patient currently receives Social Security benefits or is enrolled in the railroad
    retirement system.
  • The patient is younger than 65 years old and has received Social Security disability
    benefits for at least two years (24 months).
  • The patient suffers from permanent kidney failure.

If the patient is 65 or older and still working, will Medicare pay for home health service?
Yes, a patient can use Medicare. However, if a patient is covered by an employer's insurance plan, the employer's health insurance could be used in conjunction with Medicare.

Are home visits covered under Medicare?
Yes, if each of the following conditions is met:

  • The patient's physician has requested home healthcare and established a plan of care.
  • The agency is Medicare-certified.
  • The patient cannot leave home without assistance.
  • The patient requires nursing care, physical therapy or speech therapy that is reasonable and necessary throughout the patient's episode of care.

Do patients have to pay Choice Home Care for visits?
No. Choice Home Care will bill Medicare directly. Medicare has two parts:

  • PART A - hospital insurance that is part of the patient's Social Security benefit
  • PART B - medical insurance the patient pays for monthly

Do patients decide whether to use Part A or Part B of Medicare?
No. Part A and Part B will pay for covered home health-care services. Choice Home Care will inform the patients of their coverage.

Does Medicare cover outpatient physical therapy?
Yes, if the physician refers the patient and the patient qualifies for outpatient therapy.

Does Medicare pay for Non-Medcal Personal Home Care services?
No, Medicare does not cover Non-Medical Personal Home Care.

Are services for mental illness covered?
Yes, if the patient qualifies for home healthcare under Medicare.

Additional questions regarding coverage should be directed to an Choice Home Care nurse or a local Choice Home Care office. Additionally, local Social Security offices may provide further information.

Yes, Medicare covers hospice services and home health care visits for qualifying patients. See if you qualify

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