Frequently Asked Questions

  1. Who can get a Medicare covered home healthcare services? A Medicare beneficiary must meet the following requirements:
    • normally confined or unable to live home
    • under a physicians care
    • receiving services under a plan of care established and reviewed periodically by a physician
    • needs skilled nursing care or an intermittent basis or physical or speech therapy
    • continued need for occupational therapy
    • a physician certification
  2. What Home Healthcare services does Medicare cover? If you are a Medicare beneficiary and meet the home health requirements, Medicare will cover the following home health service:
    • Skilled Nursing Care on a part time or intermittent basis
    • Home Health Aide services on a part time or intermittent basis
    • Physical Therapy
    • Occupational Therapy
    • Speech Therapy
    • Medical social services
    • Certain medical supply, like wound dressing

    And 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.

  3. What isn’t covered, under Home Healthcare or Hospice Medicare benefits?
    • 24-hour-a-day care at home.
    • Meals delivered to your home.
    • Homemaker services like shopping, cleaning, and laundry when this is the only care you need, and when these services aren’t related to your plan of care.
    • Personal care given by home health aides like bathing, dressing, and using the bathroom when this is the only care you need.
  4. What is a Plan of Care? Your home health, palliative, hospice agency will work with you and your doctor to develop your plan of care. A plan of care lists what kind of services and care you should get for your health problem. You have the right to be involved in any decisions about your health.
  5. Your plan of care includes the following:
    • What services you need
    • Which health care professionals should give these services
    • How often you will need the services
    • The medical equipment you need
    • What results your doctor expects from your treatment
  6. Where do I get help with questions about home health and hospice coverage? If you have questions about your Medicare home health care coverage or hospice benefits and you’re in Original Medicare, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you get your Medicare benefits through a Medicare health plan, call your plan.
  7. How do I receive hospice care? To be  eligible for hospice care your doctor must write an order for hospice care, complete a certificate of terminal illness which indicates a life expectancy of six months or less, and patients must have a qualifying diagnosis. Families and patients agree to cease any curative treatment options in favor of palliative pain management and comfort care in the home environment of their choice. Patients can enjoy life on their terms, with support and care from your family and our team.
  8. Under hospice care, what  happens if the patient remains stable for a period of time and is no longer considered eligible for care? Patients who no longer qualify for hospice care due to symptom/illness stabilization or family choice, may be transitioned to our palliative program and continue to be monitored on a monthly basis, while pain and symptoms continue to be managed with medications. Under palliative care patients may also elect to engage in physical/occupational/speech therapies or other curative treatment options.
  9. I signed my loved one up for hospice, but we have changed our minds, what are our options? Hospice patients or their legal representatives play an ongoing role in the plan of care and if at any time they decide to explore other treatment options or care, they can simply revoke the hospice agreement.
  10. Under hospice must my loved one remain home in bed? No! Hospice patients are encouraged to continue to engage in the activities they feel able to participate in outside of the home environment. They are encouraged to spend time with family and friends, doing things they enjoy while our team provides support, pain and symptom management.