Certain criteria apply for Medicare/Medicaid to cover the costs of medical home health care and hospice home health care.
Medicare-covered Medical Home Health Care
Client must meet three requirements:
- Client’s physician must order for care at home.
- Client has a need for at least one of the following: skilled nursing care, physical therapy, speech-language therapy, occupational therapy (in conjunction with PT).
- Client must be homebound, meaning:
- Client is unable to leave home without assistance.
- Leaving home takes considerable and taxing effort.
- Client may leave home for medical visits or short, infrequent trips for religious services, hair appointments, etc.
- Client does not have to be bedbound to be considered homebound.
- A client can be temporarily homebound due to post-surgery restrictions that require skilled treatment.
Medicare-covered Hospice Care
Client must meet four requirements:
- Client is diagnosed with a life-limiting illness.
- Client is no longer seeking curative or aggressive treatment for life-limiting illness.
- Client’s life expectancy may be six months or less if illness is allowed to run natural course.
- Client’s physician orders hospice care.
Coverage for Medical Home Health Care and Hospice Care
Medicare, Medicaid and private insurance typically cover the majority of home health care and hospice care services. Medicare Part A covers both medical home health care and hospice home care. Part B also covers medical home health care.
Coverage for Life Care Services
THA Group’s Independent Life at Home and Ideal Aging accept private insurance, long-term care insurance and self pay.
THA Group accepts Medicare, Medicaid, private health insurance, long term care insurance and self pay. Contact us at 1.888.842.4663 with questions about coverage and services.