More Information about Home Health Care

Home health care for Chronic Condition

Once you meet Medicare’s home health eligibility requirements, Medicare will cover your care regardless of whether your condition is temporary or chronic.

Medicare covers skilled nursing and therapy services as long as they:

Help you maintain your ability to function
Help you regain function or improve
Or, prevent or slow the worsening of your condition

Providers and agencies may worry that Medicare will not cover skilled home care if you are no longer showing signs of improvement. However, Medicare will not deny your home care because your condition is chronic or unchanging, or when additional care will not improve your ability to function, as long as the care is medically necessary to maintain your condition or to prevent or slow deterioration.

If you have chronic care needs, it may be hard to find a home health agency (HHA) willing to provide you with services. If you have Original Medicare, call 1-800-MEDICARE for a list of HHAs in your area. If you have a Medicare Advantage Plan, contact your plan for a list of in-

network HHAs.

HOW TO START HOME HEALTH CARE

The process for starting the Medicare home health benefit changes depending on whether you are currently in a hospital or if you are already at home. Remember, in both cases, you must meet the eligibility requirements and qualify for coverage under either Part A or Part B.

Hospitalized: A hospital social worker or discharge planner should arrange for a Medicare-certified home health agency (HHA) to visit you and assess your condition. If you qualify, you should receive home health care after being discharged.
At home: Speak to your doctor about your home health needs and ask for a list of Medicare-certified HHAs. You, your doctor, or a caregiver should be able to call an HHA directly and ask them to visit your home and assess your condition. You should also be able to find local HHAs through your hospital discharge planning office, 1-800-MEDICARE, or the Eldercare Locator.

In either situation, the HHA should evaluate your home health needs and create a plan of care. Your doctor must certify that you qualify for Medicare’s home health benefit, sign off on the plan of care, and recertify the plan every 60 days.

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