Hello!

Home health services and home care services serve distinct purposes. Home care focuses on non-medical daily tasks for individuals who need assistance with everyday activities. This can include help with medical appointments, senior transportation, grocery shopping, bathing, meal preparation, medication reminders, and other personal care needs.

Home health services, on the other hand, address specific medical needs prescribed by a doctor. These services involve healthcare professionals providing ongoing medical care in the home. 

How to Qualify for Medicare Home Health Benefits

To qualify for Medicare home health benefits, an initial evaluation of physical health is required. Since most home health agencies assign and oversee healthcare providers, it’s essential to understand the specific health criteria they follow to ensure eligibility. Medicare-certified agencies adhere to specific standards.

Medicare covers your home health care if:

• You receive care from a Medicare-certified home health agency (HHA), like Tri-County Home Care.
• You are homebound, meaning it’s very difficult for you to leave home without help.
• You require skilled nursing or therapy (physical, speech, or occupational) on an intermittent basis. Intermittent care means you need assistance at least once every 60 days but no more than once a day for up to three weeks (this period can extend if your care needs are predictable and temporary).
• You have a face-to-face meeting with a doctor within 90 days before starting home health care, or within 30 days after care begins. This can be done via an office visit, hospital visit, or in some cases, a virtual meeting.
• Your doctor signs a home health certification confirming your homebound status and need for intermittent skilled care. The certification must also confirm the doctor’s approval of a care plan and that the face-to-face meeting requirement was met.
• Your doctor reviews and re-certifies your home health plan every 60 days.

Note: Medicare will not cover home health care if you only need occupational therapy. However, if you qualify for other home health services, you can also receive occupational therapy. When other care ends, occupational therapy may continue to be covered under Medicare’s home health benefit if you still need it.

A comprehensive medical evaluation will determine eligibility for Medicare home health services.