Here are the requirements:
1. You must be under care of a doctor, and the services you get must be under a plan of care established and reviewed regularly by this doctor.
2. A doctor must certify that you need at least one of:
- Intermittent skilled nursing care
- Physical therapy
- Continued occupational therapy
- speech-language pathology services
4. A doctor must certify that you are homebound, which means:
- Leaving home takes "a considerable and taxing effort," and therefore leaving home isn't recommended because of your condition.
- Your condition doesn't let you leave home without help from another person, a wheelchair or walker or other form of special transportation.
So long as your doctor doesn't discontinue your certification for services, and so long as the care is needed less than 7 days per week or less than 8 hours a day for 21 days. Some exceptions are made under special circumstances, but they don't detail those here.
Just so you know, Medicare will cover nearly everything, so don't feel afraid of the cost of letting us help. There are only a few things Medicare doesn't cover:
- Medical services or supplies that you agree to pay out of pocket for. Before you agree on this, we (or any other home care agency) would give you a Home Health Advance Beneficiary Notice.
- 20% of the Medicare-approved amount for Medicare-covered medical equipment like oxygen equipment, walkers, and wheelchairs.
- Private duty care(which we offer, Medicare just doesn't pay for it), like:
- 24-hour-a-day care at home
- Care (like bathing, dressing and using the bathroom) given by home health aides when this is the only care you need
- Services not outlined by your plan of care, like housemaking services (shopping, laundry, cleaning) when this is the only care you need
- Meal delivery
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