Care At Home           

Frequently Asked Questions

Home Health & Medicare:

Can I qualify for home health under Medicare?

Medicare pays for health care in a patient’s residence only if all four of the following conditions are met:

1.     The patient must need intermittent skilled nursing care, physical therapy, speech therapy, or continuous occupational therapy.

2.     The patient must be homebound. (See explanation below)

3.     The patient is under the care of a physician who determines the need for home health care and subsequently sets up and periodically reviews a home health plan of care. A patient cannot have home care without a physician’s order.

4.     The home health agency serving the patient is approved for payment by the Medicare program.

Home Health & Medicaid:

Can I qualify for home health under Medicaid?

Medicaid pays for health care in a patient’s residence only if:

1.     The patient qualifies for state Medicaid program.

2.     The patient must need intermittent skilled nursing care or therapy. Certain limitations apply.

3.     The patient is under the care of a physician who determines the need for home health care and subsequently sets up and periodically reviews a home health plan of care. A patient cannot have home care without a physician’s order.

4.     The home health agency serving the patient is approved for payment by the Medicaid program.

Home Health & Private Insurance:

Will private insurance cover home health?

Private insurance coverage for health care in the patient’s residence varies from policy to policy. To determine your policies coverage, please contact your policy provider.

Homebound (According to the Medicare Manual, Section 2051.1):

Patient’s may be considered homebound if absences from the home are infrequent or for periods of relatively short duration or attributable to the need to receive medical treatment. Generally speaking, a beneficiary will be considered homebound if he/she has a condition due to an illness or injury which restricts his/her ability to leave his/her place of residence except with the aid of supportive devices such as crutches, canes, wheelchairs, and walkers, the use of special transportation, or the assistance of another person, or if he/she has a condition which is such that leaving his/her home is medically contraindicated.

Payette Office:                                            Caldwell Office:                                     Council Office:

501 N. 16th St #112                                  504 N 10th Ave                                      102 California --PO Box 415

Payette, ID 83661                                      Caldwell, ID 83605                                Council, ID 83612
(208) 642-1838                                          (208) 453-2659                                     (208) 253-4207

Fax: (208) 642-3088                                  Fax: (208) 454-0854                             Fax: (208) 253-4959

Toll Free: 1-866-311-7773