Medicare Advantage Plans must follow Original Medicare’s rules for providing you care, but they can impose different costs and restrictions. You may need to choose a home health agency (HHA) that contracts with your Medicare Advantage Plan (private health plan) to get care. You may also have to get your plan’s prior approval or a referral before receiving home health care. Although Original Medicare does not charge a copayment, some Medicare Advantage Plans do.
If no HHA in your plan’s network will take you as a patient, call your plan. Your plan must provide you with home health care if your doctor says it is medically necessary.
If no network HHA will take you, but a non-network one will, your plan must pay for your care that you receive from the non-network HHA. If you cannot find an HHA in your area that is able to take you as a patient, talk with your doctor and your plan about other options that are available to you.
Call your Medicare Advantage Plan for more assistance.