Medicare
Medicare beneficiaries may qualify for covered home health and related services if the following criteria are met:

• The person must be under the care of a physician who determines the need for home health care and sets up a plan of care.
• The person is confined to the home (homebound).
• The care needed includes intermittent skilled nursing care, physical therapy, or speech therapy for a specific period of time.
• The home health agency providing services participates in Medicare. The Home Care Network participates in Medicare.

When Medicare Part A is billed for home health services, payment is accepted as payment in full for services provided. . There are no deductibles or co-insurance requirements for these services.

Managed Care and Private Insurance Plans
Most managed care and private insurance plans utilize the Medicare criteria for covering home health services. Pre-authorization of services is required by most managed care and private insurance plans. If the authorization is not obtained then payment may be denied by the insurance company. The Home Care Network will assist with obtaining the authorization.

Some managed care plans require co-payments for home health visits. Please check with your plan to determine your level of benefits.