How does coverage work for Home Health Care services?
We understand that Insurance and Medicare paperwork can be frustrating and confusing. This is why All County Home Care has experts to help you; so please don’t jeopardize your health because of the paperwork. The All County Home Care team will work with you to make sure you and/or your loved one have all of the necessary forms and authorizations to begin or continue care.
Private/Group Health Insurance
ACHC currently accepts the following insurance:
The costs of skilled (RN, LVN, PT, OT, ST) home health care services are generally covered by private/group insurance with pre-approval from the insurance company, or by private funding. Personal care services (bathing provided by aides) are generally only covered by long-term insurance companies with daily or annual maximums. All County Home Care benefit experts can help answer any questions you may have concerning eligibility and coverage. For qualified patients, Medicare pays 100% of the cost for skilled home health care from ACHC. There are no deductibles, co-pays, or any other out-of-pocket expenses for patients paying with Medicare. To qualify, a patient must meet Medicare’s definition of homebound. Medicare (and many private insurance companies) will help cover home health costs for beneficiaries who meet four conditions (Note: this applies to the Medicare home health benefit, not the Medicare hospice benefit):
You must be homebound. This means that:
- Leaving home is a major effort.
- You are normally unable to leave home unassisted.
- When you leave home, it must be to get medical care, or for short, infrequent non-medical reasons such as a trip to get a haircut, or to attend religious services or adult day care.
Your doctor must decide that you need medical care at home, and make a plan for your care.
You must need at least one of the following: intermittent skilled nursing care or physical therapy or speech-language therapy or continue to need occupational therapy.
The home health agency caring for you must be approved by the Medicare program.