Home Health Providers

Medicare covers home health when your loved one is homebound, has a doctor's order, and the care is medically necessary. The agency must also be Medicare-certified. There's no copay for covered services under Medicare Part A or Part B. Medicare does not cover 24-hour care, meals, or personal care unless skilled care is also being provided at the same time.

Ask your loved one's doctor for a home health referral. The doctor will order the services and the agency will complete an intake assessment — usually within 24 to 48 hours of the order. If your loved one is being discharged from a hospital, the hospital social worker can often arrange home health as part of the discharge plan. Most agencies can begin within a few days of the order.

Homebound means leaving home requires considerable effort — due to illness, injury, or a medical condition. Your loved one doesn't have to be completely bedridden. Someone who can leave occasionally for medical appointments, adult day care, or brief outings can still qualify. The key is that leaving home is taxing and not routine. A doctor must certify homebound status.

Home health is short-term and goal-directed — typically weeks to a few months. Medicare reviews eligibility every 60 days. If your loved one still qualifies and has a continuing medical need, services can continue. When the clinical goals have been met or your loved one is no longer homebound, services typically end. A good agency will help you plan for what comes next.

Home health is skilled medical care — nursing, therapy — ordered by a doctor and often covered by Medicare. Home care is non-medical support — bathing, meals, companionship — typically not covered by Medicare. Many families need both at different times. Home health usually comes first after a hospitalization, and non-medical home care often continues afterward.

Medicare's Care Compare tool rates home health agencies on quality measures and patient outcomes — it's a useful starting point. Beyond ratings, ask agencies about their caregiver consistency (will you see the same nurse most visits?), how they coordinate with your loved one's doctor, and what their process is for discharge planning. Agencies in tendercare's Trusted Network have already been vetted against these criteria.

If your loved one doesn't meet Medicare's homebound requirement or doesn't have a qualifying medical need, home health services can still be arranged on a private-pay basis. Rates vary widely by region and by the type of service. Long-term care insurance may cover private-pay home health — check your policy. A geriatric care manager can also help identify other funding options.