Medicare will help pay for your home care if:
- You are homebound, meaning it takes a considerable and taxing effort to leave your home, for example you need crutches, a walker, a wheelchair or help from another person; and
- You need skilled nursing care on a part-time (less than eight hours a day) or intermittent basis (as little as once every 60 days to as much as daily, for three week periods, if there is a predictable end to your need for care) and/or you need skilled therapy services (physical, speech, occupational therapy*); and
- You have a plan of care approved by a Medicare-enrolled doctor; and
- You receive your care from a Medicare-certified home health agency (HHA).
To learn more, click on the links in the GO TO box.
Regional Home Health Intermediaries (RHHIs) handle home health and hospice claims.
You can call your intermediary for claim issues, and questions about coverage, complaints or denials.
To find your Regional Home Health Intermediary, call 1-800-MEDICARE or click on the link in the LINKS box.
*If you only need occupational therapy, you will not qualify for the Medicare home health benefit. However, if you qualify for Medicare coverage of home health care on another basis, you can also get occupational therapy. Even when your other needs for Medicare home health end, you should still be able to get occupational therapy under the Medicare home health benefit if you continue to need it.
Note: In 2008, Medicare began replacing fiscal intermediaries, carriers and regional home health intermediaries with Medicare Administrative Contractors (MACs). These MACs will process claims for both Medicare Part A and Part B in assigned regions. There are 15 A/B MAC regions. To find out who you should call with billing issues and whether your state has been assigned to a MAC region, call 800-MEDICARE.
