SJC Home Health Care, Inc. accepts various coverages on a case-by-case basis. Prior authorization/pre-certification is required for all Private and Managed Care Insurances. If you are uncertain about the client’s eligibility for home health services, please feel free to contact us.
Eligibility Requirements for Medicare Home Health Benefits
The following information is extracted from the booklet “Medicare and Home Health Care” published by Medicare, which outlines the rules for Medicare Home Health Care eligibility and covered services.
If you have Medicare, you may utilize your home health benefits if you meet all of the following conditions:
- You must be under the care of a doctor, and you must be getting services under a plan of care established and reviewed regularly by a doctor.
- You must need, and a doctor must certify that you need, one or more of the following.
- Intermittent skilled nursing care
- Physical therapy
- Speech-language pathology services
- Occupational therapy
- The home health agency caring for you must be approved by Medicare. SJC Home Health Care, Inc. is Medicare-certified.
- You must be homebound, and a doctor must certify that you’re homebound. To be homebound means the following:
- Leaving your home isn’t recommended because of your condition
- Your condition keeps you from leaving home without help (such as using a wheelchair or walker, needing special transportation, or getting help from another person)
- Leaving home takes a considerable and taxing effort
Individuals are permitted to leave their homes for medical treatment or brief and occasional absences for non-medical purposes, such as attending religious services. If you attend adult day care, you can still receive home health care services; however, these services will be provided in your own home.
To learn more about the requirements for home health care, please contact us.