Medicare and Continuing Care
Frequently Asked Questions
11. Who is eligible for the Medicare home health benefit?
If a patient has Medicare, he or she can use the home health benefit if all of the following conditions are met.
- The doctor must decide that the patient needs medical care at home and makes a plan for this care.
The patient must need one or more of the following services.
- intermittent skilled nursing care
- physical therapy
- speech-language pathology services
- continued occupational therapy
- The home health agency selected must be approved by the Medicare Program (Medicare-certified).
- The patient must be homebound or normally unable to leave home unassisted. To be homebound means that leaving home takes considerable effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as a trip to attend religious services. A person can still get home health care if he or she attends adult day care.
To find out if a patient is eligible for Medicare's home health care services, call the Regional Home Health Intermediary (RHHI). A RHHI is a private company that contracts with Medicare to pay bills and check on the quality of home health care. To contact a RHHI, call 1-800-Medicare (1-800-633-4227) or visit http://www.medicare.gov. TTY users should call 1-877-486-2048.