Eligibility
When someone is not feeling well the last thing
in the world they need is unexpected or confusing bills for home
care. The VNA of Rhode Island will always discuss and or assist
with payment options and insurance coverage with patients;
caregivers, and discharge planners before services begin.
Are you eligible for home health
care?
Have you recently undergone
surgery, or have an unstable medical condition?
Are you a caregiver for someone
who has had surgery or an unstable medical condition?
Are you planning to have surgery
in the near future?
If you said yes to any of the above questions you
may be eligible for home health care.
Medicare eligibility information:
Medicare pays for home health care when the
patient has been hospitalized or has an unstable medical
condition requiring the need for services of skilled
professionals for a limited duration.
Medicare has the following conditions that must
be met to qualify for home health care:
You must be homebound. This means that you are
unable to manage on your own to leave your home. Please note
that going to church, doctor appointments, and an adult day care
could still possibly fall into the realm of being homebound
according to an updated definition.
You are under the care of a physician who
approves and signs orders for the nurse or therapist to provide
home care.
You require
skilled care that can be provided by only a licensed-trained
health care professional.
Care must be able to be provided on an
intermittent basis. Your doctor will order professional staff
to go to your home and provide assessment, treatment, and
teaching.
Your physician–directed plan of care must be
reasonable and necessary to your diagnosis. Once your condition
improves or becomes stable, you will no longer meet the
requirements of Medicare home health services.
****Please note that many private
insurance companies and Medicare assignment plans vary
tremendously in their coverage of home health services. The
only way to be absolutely sure is to ask your insurance company.
