Home Health is a wonderful service that can help you recover from an illness or injury in the comfort of your own home. At Western Health HomeCare we are asked everyday how a person can be qualified to recieve Home Health care. Below are the rules regarding Home Health qualifications from Medicare. (http://www.medicare.gov/Publications/Pubs/pdf/10969.pdf)

“Who’s eligible?

If you have Medicare, you can use your home health benefits if you meet all the following conditions:

You must be under the care of a doctor, and you must (1.) be getting services under a plan of care established and reviewed regularly by a doctor. You must need, and a doctor must certify that you need (2.) one or more of the following:

Intermittent, skilled nursing care

Physical therapy

Speech-language pathology services

Occupational therapy

The home health agency caring for you must be approved (3.) by Medicare (Medicare-certified). You must be (4.) homebound, and a doctor must certify that you’re homebound. To be homebound means the following:

Leaving your home isn’t recommended because of your condition.

Your condition keeps you from leaving home without help (such as using a wheelchair or walker, needing special transportation, or getting help from another person).

Leaving home takes a considerable and taxing effort.

A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as attending religious services. You can still get home health care if you attend adult day care, but you would get the home care services in your home.

Eligibility is also based on the amount of services you need

If you meet the conditions above, Medicare pays for your covered home health services for as long as you’re eligible and your doctor certifies you need them. If you need more than part-time or “intermittent” skilled nursing care, you aren’t eligible for the home health benefit.

To decide whether you’re eligible for home health care, Medicare defines part-time or “intermittent” as skilled nursing care that’s needed or given on fewer than 7 days each week or less than 8 hours each day over a period of 21 days (or less) with some exceptions in special circumstances. Hour and day limits may be extended in exceptional circumstances when your doctor can predict when your need for care will end.”

I hope this information helps in your choice to decide which level of care is appropriate for you and your loved one. If you have any questions about Home Health qualifications you can call us at (619) 397-7800 or email us at [email protected].