How to Find Medicare-Approved Home Health Care Agencies

More than 61 million Americans are currently enrolled in Medicare programs.^[01] Medicare covers a range of senior services from hospital bills, prescriptions and immunizations, hospice care, and more. And for seniors who have serious medical problems that make it tough for them to leave the house, Medicare covers many home health care services.

Home health services that are covered by Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) include the following:

• Part-time skilled nursing care, which may include wound care, vital sign monitoring, and medication administration
• Physical, occupational, or speech therapy
• Medical equipment and supplies needed to provide care at home

Let our care assessment guide you

For your parent’s Medicare plan to cover costs, these services must be provided by Medicare-approved home health care agencies. Using a health care provider outside of the Medicare network will put seniors at risk of covering their own medical bills in full.

Read more:Does Medicare Cover Palliative Care at Home?

Eligibility for home health care varies. Seniors enrolled in Medicare must meet specific criteria to take advantage of home health care services. The following eligibility requirements have been established by the Centers for Medicare and Medicaid:

• Medicare beneficiaries must be classified as homebound, meaning their doctor has certified that they have significant trouble leaving the house without help due to illness, injury, or for other health reasons.
• A doctor has recently created a plan of care and confirmed that a senior needs in-home skilled nursing care or therapy services.
• Care is only needed on a part-time basis, meaning that seniors only require in-home care for a maximum of eight hours a day or less than 28 hours each week.
• The chosen home health care agency is Medicare-certified.

Talk with a Senior Living Advisor

For seniors with Original Medicare coverage who meet the criteria above, Medicare will cover 100% of home health services. Medicare Part B will cover at-home medical equipment once enrollees meet their deductible. Be sure to reach out to your parent’s Medicare representative to get a full picture of their plan and what’s included.

If there are additional resources or services that aren’t covered by Medicare, home health care agencies are required by law to share those costs up front. This notification, called the Advance Beneficiary Notice (ABN), is put in place to protect seniors from incurring additional out-of-pocket costs.

Is home health care right for my parent?

Home health services are beneficial to seniors with challenging, chronic, and progressive conditions. They also help older adults who are recovering from an illness or recuperating after surgery. For many seniors, leaving the house requires the help of mobility aids, assistance from family members, and the support of friends who drive them to doctor’s appointments. Getting care at home can reduce the stress and anxiety of frequent, unnecessary trips to the doctor.

While many seniors need help with medical issues, some seek companion or home care, too. This type of support may include housekeeping, meal planning and preparation, and personal care services like help with activities of daily living. Before starting your search for in-home care, remember that there’s a big difference between home care and home health care and know that nonmedical services typically aren’t covered by Medicare.

Read more:Medicare, Medicaid, and Long-Term Care

Medicare’s electronic, interactive search engine allows seniors and families to find approved home health providers by location. The site includes agency contact information, highlights what services a provider offers, and even features patient ratings on a five-star scale. Because it only returns agencies that are already Medicare certified, the search for home health care is a lot more manageable than doing online research completely on your own.

Medicare has also created a comprehensive list of all registered home health care agencies. Here, you can browse by provider name, type of ownership, unique or special services offered, and more.

Seniors seeking home health services should also be encouraged to talk to friends and other family members about local care agencies they’ve had positive experiences with. Your loved one’s doctor is also a great resource who can likely provide a list of home health providers they know and trust.

How do home health care agencies receive Medicare approval?

Licensed home health care providers must navigate an in-depth application process to become certified by Medicare. Home health agencies will typically hear back within six months on whether their applications were approved or denied. If they’re approved by Medicare, there are more steps to complete. Home care providers must submit federal forms, internal documents, and detailed reports on how they comply with key policies like nondiscrimination, civil rights requests, and more.

As of 2020, there were a reported 11,221 Medicare-certified home health agencies across the U.S. ^[02] who strive to help seniors retain their independence while getting essential medical support.