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Paying For Home Health Care

How Do I Qualify For Home Health Services?

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The following are some of the criteria that may be required to obtain home health care.

Your doctor must agree that you require home health care.

A prescription from your doctor is generally required to obtain professional services such as skilled nursing care, infusion services, and physical, rehabilitation and occupational therapies.

Supportive care services such as those provided by a home health aide or homemaker do not generally require a doctor's consent, although some of these services may not be covered by your insurance provider if not provided with your doctor's consent.

Your insurer may have requirements that must be met in order to provide coverage.

For example, Medicare / Medicaid requires that you be home bound and in need of skilled nursing services before coverage takes effect. Medicare and Medicaid also require that an agency be certified.

Managed care insurance plans may require that you use only agencies with which they are contracted to provide services. (To learn more, see: Types of Health Insurance Policies).

Home health agencies may have their own admission requirements

For example, some agencies only work with patients who reside in a specific area.

Agencies have the right to deny service if they feel that your medical condition requires complex medical treatments that they are not capable of providing.

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