Medicare Home Health Requirement for Coverage

Update: CMS has given home health agencies and hospices until April 2011 to fully implement this requirement. Agencies will have this period to implement procedures and ensure full compliance.

As of January 1, 2011 there will be new requirements for receiving home health services covered by Medicare. Patients receiving Medicare coverage for home health care services must now have a face to face visit with their physician within a certain time frame to certify eligibility. There are some more detailed requirements such as: the visit must be within 90 days prior to home health services starting or within 30 days after, the reason for the visit must relate to the need for in home care and the physician must be the same one that is managing the patient’s care plan (though hospitalists have been included as allowed under this requirement).

This new regulation intends to ensure better physician involvement and oversight, but also creates some challenges for patients. To be eligible for Medicare to cover home health services, a person must be “homebound”, which means it is a taxing effort and challenging for them to get out to appointments. Many eligible patients no longer drive.

If you encounter this concern for yourself or someone you care about, EasyLiving can be a resource for your home health services needs. We offer transportation services and we are glad to help get you to your necessary doctor’s visit. Since we are all about making life easy, we offer timely response and flexible scheduling to meet your transportation needs. One of our highly qualified and extensively screened home health aides can provide door to door transportation, safe escort in and out of the car and any physical assistance you need. They can help getting a walker or wheelchair in and out of the car and ensuring a safe visit. If desired, they can even run additional errands or help with other appointments as well.

We collaborate with other professionals and home health service providers who encounter clients needing help with transportation, whether for a necessary doctor’s appointment or other needs. Learn more about what Medicare covers for home health services and coverage limitations here.

Have questions about the new 2011 Medicare home health services requirements, request a complimentary consultation today!


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