FAQ
Frequently Asked Questions (FAQs)
General Questions
Q: What is home health care?
A: Home health care provides skilled medical services to patients in their homes. It includes nursing care, physical therapy, occupational therapy, speech therapy, and medical social work, among other services.
Q: Who qualifies for Medicare-covered home health care?
A: To qualify for Medicare-covered home health services, a patient must:
- Be under the care of a doctor who certifies the need for home health services.
- Require skilled nursing care or therapy services.
- Be homebound, meaning leaving home requires a considerable effort.
- Receive care from a Medicare-certified home health agency.
Q: What types of services are covered by Medicare?
A: Medicare covers:
- Skilled nursing care (wound care, injections, medication management, etc.).
- Physical, occupational, and speech therapy.
- Medical social services.
- Home health aide services (when skilled care is also needed).
Q: What services are NOT covered by Medicare?
A: Medicare does not cover:
- 24-hour home care.
- Personal care (bathing, dressing, meal preparation) if that’s the only care needed.
- Homemaker services.
- Long-term or custodial care.
Coverage & Costs
Q: Does Medicare pay for 100% of home health care?
A: Yes, Medicare Part A and/or Part B cover home health services at no cost to the patient for eligible services. However, durable medical equipment (DME), such as wheelchairs and walkers, may require a 20% coinsurance payment.
Q: How long will Medicare cover home health care?
A: Coverage is provided as long as the patient continues to meet Medicare’s eligibility criteria. A doctor must review and recertify the care plan every 60 days.
Q: Do I need prior hospitalization to qualify for home health care?
A: No, Medicare does not require a prior hospital stay to qualify for home health care services.
Receiving Care
Q: How do I start home health care services?
A: To begin services:
- Talk to your doctor about your need for home health care.
- Your doctor will order home health services from a Medicare-certified agency.
- A home health agency will schedule an evaluation and start your care.
Q: Can I choose my home health care provider?
A: Yes, you have the right to choose any Medicare-certified home health agency in your area.
Q: What can I expect from my first home health visit?
A: A nurse or therapist will visit your home to assess your health needs, discuss your care plan, and coordinate services with your doctor.
Other Important Questions
Q: Can I receive home health care if I live in an assisted living facility?
A: Yes, as long as you meet Medicare’s eligibility requirements, you can receive home health services even in an assisted living facility.
Q: What happens if I no longer qualify for Medicare home health care?
A: If you no longer meet Medicare’s criteria, your home health agency will notify you and discuss other care options, such as private pay services or Medicaid programs.
Q: How do I find a Medicare-certified home health agency?
A: You can search for Medicare-certified agencies at 
Medicare.gov or ask your doctor for recommendations.
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