Who Qualifies for Home Health Care Services?
Mar. 20, 2023
By Kaylee Yamry
Key Indicators and Medicare Eligibility
Do I qualify for home health care services? This is one of the most common questions we receive at Ethos Home Health Care. If you’re curious about eligibility on behalf of yourself or a loved one, you’re not alone. At the same time, finding answers isn’t always straightforward.
When to Consider Home Health Care
Before diving into eligibility, understanding when to consider home health care services is key. While everyone’s situation is unique, there are a few key questions you can ask yourself.
Am I or a loved one…
Facing a new diagnosis or a worsening medical condition?
Suffering from more frequent falls?
Visiting the hospital frequently?
Experiencing confusion after medication changes?
Struggling with basic functionality such as walking or speech?
Although these are some of the most common indicators, there are many factors that can make home health care a viable option.
Medicare Eligibility for Home Health Care
As a Medicare-certified home health agency, our Ethos family is a trusted source for accurate home health care eligibility information. There are three key criteria that must each be met.
These criteria include having a current doctor-reviewed care plan, being declared homebound by your doctor, and requiring intermittent (part-time) skilled nursing care or specific treatment services (i.e. physical therapy, speech-language pathology, or continued occupational therapy).
Of note, part-time skilled nursing care does not include blood draws. Additionally, individuals whose needs exceed part-time nursing care are ineligible.
Which Home Health Care Services are Covered Under Medicare?
In addition to physical therapy, speech-language pathology, and occupational therapy as listed above, Medicare Part A and/or Medicare Part B cover a range of home health services. All the while, our highly trained Ethos Home Health Care team is well-versed in the full spectrum of at-home therapy, skilled nursing care, and beyond.
For individuals receiving skilled nursing care services or therapies at the same time, home health aide care is covered. Additionally, coverage includes at-home medical supplies and durable medical equipment (DME) such as remote health monitoring technologies.
Likewise, coverage includes part-time skilled nursing care. This means nursing care for fewer than seven days per week or fewer than an average of eight hours per day over a 21-day period. As an important consideration, services that are not related to your care plan such as laundry, meal deliveries, or cleaning are not covered under Medicare. However, private pay is always an option for skilled care needs and services not related to care as described above.
Taking the First Step for Home Health Care Services
If you are unsure whether home health care might be right for you or a loved, we invite you to take our short assessment to help you determine whether home health care might be the right fit.
For additional questions or to discuss your options we invite you to call us at (701) 809-9319 or fill out an inquiry form. As a Medicare-certified home health care agency, our Ethos family is here with the most up-to-date information tailored to your unique situation.
For additional information, you can also visit our home health care page. Thank you for reading!