Who Qualifies for Home Health Care Services?

October 19, 2020

If you’re caring for a loved one with a chronic condition or helping them with physical therapy, you know there can be challenges. Not only can there be issues with knowing what to do, but problems finding support for yourself so you can tend to the other responsibilities in your life.

Other than moving to a community offering skilled nursing care or therapy services, one possible solution is home health services. In some cases, Medicaid and Medicare will even cover the costs of your loved one’s home health care. But how do you know who qualifies for home health care services and whether it’s the right option for your family and loved one?

Who Qualifies for Home Health Care Services?

According to the Medicare Learning Network’s (MLN) pamphlet “Medicare & Home Health Care,” for your loved one to qualify for benefits, the following five requirements must be met:

  1. Must be under the care of a doctor, and getting services under a plan of care established and reviewed regularly by a doctor.
  2. A doctor certifies that they need one or more of these:
  • Intermittent skilled nursing care (other than drawing blood)
  • Physical therapy
  • Speech-language pathology services
  • Continued occupational therapy
  1. Use a certified home health agency approved by Medicare.
  2. Have a doctor certify that they’re homebound. To be homebound means they have trouble leaving their home without help (such as a cane, wheelchair, walker, crutches, special transportation or help from another person) because of an illness or injury, or leaving their home isn’t recommended because of their condition.
  3. As part of your loved one’s certification of eligibility, a doctor, or other health care professional who works with a doctor, must document that they’ve met face to face with your loved one within the required time frames and that the encounter was related to the reason your family member needs home health care.

What’s Covered?

Traditional Medicare covers 100% of services when there’s a skilled health care need following an acute episode such as hospitalization or change in health status as long as the patient is homebound. Income is not a factor when home care services are provided due to a need under Medicare.

Medicare-certified home health agencies (CHHAs) accept most traditional Medicare benefits. For questions about which plans are accepted by McLean Home Care, please call us at 860-658-3954.

To help you evaluate providers, Home health agencies are certified by Medicare to make sure they meet certain federal health and safety requirements. You can see ratings and compare home health agencies in your area by the types of services they offer and the quality of care they provide on Medicare.gov/homehealthcompare.

Discover Our Award-Winning Care

McLean Home Care is nationally recognized for our exceptional coordinated care and specialized programming. We’ve received numerous high ratings, awards, accolades and certifications in services spanning from fewest hospitalizations to the quality of care. We also provide home health care to the following areas:

  • Avon
  • Bloomfield
  • Burlington
  • Canton
  • Collinsville
  • East Granby
  • Farmington
  • Granby
  • North
  • Granby
  • Simsbury
  • West Granby
  • West Hartford
  • Windsor

If you want to learn more about our high-quality home health services or see if your loved one qualifies for home health care services contact us here.


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