Qualifying for Home Health Care
Medicare covers home health services at no cost to you when certain conditions are met. Here’s everything you need to know about eligibility.
Medicare’s 3 Requirements
1
Doctor’s Order
A physician must certify that you need skilled medical care—such as nursing, physical therapy, or speech therapy—and order a plan of care for home health services.
2
Homebound Status
You must be “homebound,” meaning that leaving your home requires considerable and taxing effort due to illness, injury, or a medical condition. You may still leave home for medical appointments or occasional short trips.
3
Medicare-Certified Agency
Your care must be provided by a Medicare-certified home health agency.
WEL-Home Health Sergeant Bluff is a Medicare-certified agency, meeting all federal quality and safety standards.
How Home Health Works
Getting started with home health care is simple. Here’s what to expect:
1
Talk to Your Doctor
Ask your physician for a home health referral, or call us and we’ll coordinate with your doctor on your behalf.
2
Personalized Care Plan
Our clinical team works with your doctor to create a care plan tailored to your specific needs and recovery goals.
3
In-Home Care
Skilled clinicians visit your home on a regular schedule to deliver care, track progress, and adjust your plan as you improve.
What Does “Homebound” Mean?
Under Medicare guidelines, you are considered homebound if:
- Leaving your home requires considerable and taxing effort due to your condition
- You need the help of another person, a wheelchair, walker, crutches, or other assistive device to leave home
- Your doctor believes that leaving home could be harmful to your health
You can still qualify even if you:
- Attend medical appointments or receive treatments (e.g., dialysis, chemotherapy)
- Attend religious services
- Take occasional short trips (such as a walk around the block or a trip to the barber)
- Attend adult day care for therapeutic, psychosocial, or medical purposes
Services Covered by Medicare
When you qualify, Medicare covers these home health services at no cost to you:
Frequently Asked Questions
If you have Medicare and meet the eligibility requirements, you pay nothing for covered home health services. There is no deductible or copayment for home health care under Medicare Part A or Part B. Some insurance plans and Medicaid also cover home health services.
There is no specific time limit. Medicare covers home health care as long as your doctor certifies that you continue to need skilled care, you remain homebound, and you are making progress toward your care goals. Your plan of care is reviewed and recertified every 60 days.
Yes! You have the right to choose any Medicare-certified home health agency. You can ask your doctor for a referral to
WEL-Home Health Sergeant Bluff, or contact us directly and we’ll work with your physician to get the process started.
No. Unlike skilled nursing facility care, you do not need a prior hospital stay to qualify for home health services under Medicare. You simply need a doctor’s order, homebound status, and a need for skilled care.
We also accept Medicaid and many private insurance plans. Contact us at
(712) 943-7644 to discuss your coverage options—our team will help you understand what’s available.
Not Sure If You Qualify?
Our team is here to help. We’ll review your situation and work with your doctor to determine if home health care is right for you.
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