Home Healthcare Eligibility
Affilia Home Health patients must meet the eligibility criteria set by their insurance to have their care approved. Medicare and most private insurance companies require that patients be “homebound” and will approve home healthcare for beneficiaries who meet the following conditions:
- Leaving home takes considerable and taxing effort due to limited abilities to walk or to get in and out of the house or vehicle.
Your patient could need frequent rests or experience pain and exhaustion from the outing.
- Help is normally required to leave home.
This can be assistance from another person, a walker or wheelchair, or special transportation.
- Typically patients leave home to get medical care or for short, infrequent, non-medical reasons.
They may go to special family events or religious services, attend an adult day care program, visit a barber or hairdresser, or occasionally pick-up medicine and other essentials.
- A physician may verify that leaving home is against medical advice or that a patient’s cognitive impairments make him unsafe without constant supervision.
Other requirements to qualify for home health coverage include:
- The patient’s ability to participate in planning and supervising the care.
- A physician’s order that skilled nursing, physical or speech therapy, or continued occupational therapy is needed and can be safely received at home.
In addition, Medicare must certify the home health agency that provides your care. Affilia Home Health is certified by the Centers for Medicare and Medicaid Services.
Affilia Home Health does not discriminate on the basis of race, color, religious creed, gender, sexual orientation, age, sex, national origin, ancestry, physical and/or mental disability, ability to pay, or any other classification prohibited by law with regard to admission, access to treatment or employment.
Complaints of discrimination by patients, consumers or staff may be filed with the Office of Equal Opportunity (Office of Civil Rights), Pennsylvania Department of Health, and/or the Pennsylvania Human Relations Commission.Back to top