Frequently Asked Questions

What is homecare?

"Home care" is a simple phrase that encompasses a wide range of health and social services performed in the comfort of the patient’s home. These services are delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living.

Generally, home care is appropriate whenever a person prefers to stay at home

What types of homecare are there?

Skilled homecare – Nurses and therapists provide medical interventions under the direction of a physician.

Non-skilled homecare – Aides and/or homemakers provide assistance with activities of daily living (bathing, grooming, dressing, ambulation, assistance with toileting, etc…) and assistance with the home environment (meal preparation, laundry, minor house cleaning, etc…).

Do I get to choose my own home health agency?

Everyone has the right to choose his/her homecare provider.

Yes.  According to federal regulations 482.43(b)(1), “The hospital must provide a discharge planning evaluation to the patient(s)...” and this evaluation must (b)(3) “include an evaluation of the likelihood of a patient needing post-hospital services and of the availability of the services.”


Sec. 1802. [42 U.S.C 1395a] (a) BASIC FREEDOM OF CHOICE. – Any individual entitled to insurance benefits under this title may obtain health services from any institution, agency, or person qualified to participate under this title if such institution, agency, or person undertakes to provide him such services.


In other words, the health care provider must give the patient access to any needed post-hospital services including a list of who can provide the needed services.

Who pays for homecare?


Home care services that fail to meet the eligibility criteria of third-party payors must be paid for "out of pocket" by the patient or other party. The patient and home care provider negotiate the fees.


Most Americans older than 65 are eligible for the federal Medicare program. If an individual is homebound, under a physician's care, and requires medically necessary skilled nursing or therapy services, he or she may be eligible for services provided by a Medicare-certified home health agency. Depending on the patient's condition, Medicare may pay for intermittent skilled nursing; physical, occupational, and speech therapies; medical social work; Home care aide services; and medical equipment and supplies. The referring physician must authorize and periodically review the patient's plan of care. The services the patient receives must be intermittent and provided through a Medicare-certified home health agency for reimbursement.


Administered by the states, Medicaid is a joint federal-state medical assistance program for low-income individuals. Each state has its own set of eligibility requirements; however, states are only mandated to provide home health services to individuals who receive federally assisted income maintenance payments, such as Social Security Income and Aid to Families with Dependent Children (AFDC), and individuals who are "categorically needy." Categorically needy recipients include certain aged, blind, and/or disabled individuals who have incomes that are too high to qualify for mandatory coverage but below federal poverty levels.

Veterans Administration

Veterans who are at least 50% disabled due to a service-related condition are eligible for home health care coverage provided by the Veterans Administration (VA). A physician must authorize these services, which must be delivered through the VA's network of hospital-based home care units.

Commercial Health Insurance Companies

Co  Commercial health insurance policies typically cover some home care services for acute needs, but benefits for long-term services vary from plan to plan. Commercial insurers, including Blue Cross and Blue Shield and others, generally pay for skilled professional home care services with a cost-sharing provision.

Managed Care Organizations

q Managed care organizations (MCOs) and other group health plans sometimes include coverage for home care services. MCOs contracting with Medicare must provide the full range of Medicare-covered home health services available in a particular geographic area. These organizations only pay for services that are pre-approved.


On  a cost-shared basis the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) covers skilled nursing care and other professional medical home care services for dependents of active military personnel and military retirees and their dependents and survivors. CHAMPUS offers a comprehensive hospice benefit to its terminally ill beneficiaries, which covers nursing, social work and counseling services, therapies, personal care, medications, and medical supplies and equipment.

Workers' Compensation

Any individual requiring medically necessary home care services as a result of injury on the job is eligible to receive coverage through workers' compensation.


What qualifies people for skilled homecare?

Care must be ordered and reviewed by a physician

Care must be intermittent

Patient must be homebound certified by a physician (The patient can leave the home, but it is a taxing effort)

What does being “homebound” mean?

In order or the patient to receive MEDICARE home health services, the patient must be homebound or confined to his/her home.  The patient may leave the home, but requires a considerable and taxing effort.

The individual may leave home as often as necessary for medical treatment.

The individual may leave home if it is:

  • For infrequent episodes
  • For short durations
  • And requires a considerable and taxing effort

Occasional absences from the home for non-medical purposes (religious services, trip to the barber, walk around the block, a drive, attend a family reunion, funeral, or graduation).  The examples provided above are not all-inclusive and are meant to be representative of the kinds of infrequent or unique events a patient may attend.

Other insurances may require the patient to be homebound.

How do I choose a home health agency?

Speak to your physician or nurse and tell them which homecare agency you would like to provide you with care.

I received a Government survey about homecare services. What do I do with it?

Complete the survey honestly and return it as soon as possible.

Please note that your healthcare provider is not permitted to help you complete the survey.

280 East Main Street, St. Clairsville, OH 43950 740.699.7000
Click here to link to Home Health Compare.
This Site has detailed information about every Medicare-certified home health agency in the country.

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