UVM Health Network Home Health & Hospice works with all private insurance companies to achieve the best outcome for your patients. Our insurance specialists work with private insurers on a daily basis and can help answer questions about what services can be covered and what, if any, liability your patient may incur. We will also obtain prior authorization if needed.

Understanding Medicare Coverage for Home Health

Medicare pays 100% of home health care and services when the patient requires skilled care and is considered homebound. If you have questions about eligibility, we encourage you to contact our Intake and Referral staff.  We can arrange an evaluation visit with your patient to determine coverage.

What are examples of skilled care?

  • Management and assessment of health condition by a registered nurse
  • Rehabilitative therapies provided by physical, occupational or speech therapists
  • Wound, ostomy, IV, tube feedings and continence care/education
  • Social work and an LNA may be provided only when nursing or therapy care is required in the plan of care

What qualifies a person as homebound?

  • The patient has a condition due to an illness or injury that restricts the ability to leave home
  • Leaving home requires a considerable and a taxing effort
  • Absences from the home are infrequent, for relatively short duration or are to receive healthcare treatment