Medicare home health benefit

What you need to know when ordering home health care.

As you might imagine, Medicare has extensive guidelines for the types of services we offer. At Aurora Health at Home, we know making sense of these rules can be challenging for health care professionals. Our guide can help you easily find what you need to know.

Remember, Medicare’s criteria for home health care differs from that for medical equipment, hospice or infusion therapy.

Home health

For Medicare to cover someone’s home health care, the following criteria must be met:

• The person is enrolled in Part A and/or Part B of the Medicare program.
• The person meets the criteria for home health services.
• The home health agency providing the care has an agreement to participate in the Medicare program. (Aurora Health at Home is an approved participant.)
• The Medicare home health benefit covers the services you are prescribing – intermittent skilled nursing, physical therapy, speech therapy and/or continuing occupational therapy.
• Medicare is the appropriate payer.

Hospice care

For people seeking end-of-life care, Medicare covers hospice services. To ensure coverage, the person who wishes to receive hospice services must meet these requirements:

• Be enrolled in Medicare Part A
• Have a life expectancy of 6 months or less, as determined by both a hospice doctor and you, the primary doctor
• Accept palliative care (or comfort care) in place of curative care for the illness
• Sign an agreement to choose hospice care instead of other Medicare-covered benefits to treat the terminal illness or condition

Learn more about our hospice care

Home infusion

People receiving infusion therapy require coverage for:

• Infusion medication and equipment: Medicare Part A covers infusion pumps and some infusion medications as durable medical equipment (DME). If you care for people whose medication is not covered through Medicare Part A, they should check their prescription plans for alternate coverage.
• Any skilled nursing needed: For skilled nursing, people must meet Medicare’s criteria for home health care.

Learn about home infusion at Aurora Health at Home

Home medical equipment

Home medical equipment is fully covered by Medicare Part B when you prescribe it for use in someone’s home. Keep in mind, both the prescriber and the DME supplier must be enrolled in Medicare. Aurora Health at Home participates in the Medicare program.

See what home medical equipment is available through Aurora Health at Home

Choose home care you can trust

Aurora Health at Home makes it easy to refer the patients you treat.

Refer your patient

Join our team

Aurora Health at Home is looking for compassionate home health team members.

Learn more about working for Aurora Health