Eligibility

Home Health Care Eligibility

All services provided by Community Health Center are under the supervision of your doctor, who orders and plans your care at home. CHC directly bills Medicare, Medicaid, or private insurance on your behalf.

Medicare & Medicaid

Home health care services that may be covered by Medicare and Medicaid include skilled nursing care; home health aides; rehabilitative physical, speech and occupational therapies; social work services; and medical equipment and supplies.

You can use your home health benefits if you meet all the following conditions:

1. A doctor must certify that you need one or more of the following:
   • Intermittent skilled nursing care
   • Physical therapy
   • Speech-language pathology services
   • Continued occupational therapy
2. A doctor must certify that you are homebound. This means:
   • Leaving your home isn't recommended because of your condition
   • Your condition keeps you from leaving home without help (such as using a wheelchair or walker, needing special transportation, or getting help from another person).
   • Leaving home takes a considerable and taxing effort.

A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as attending religious services. You can still get home health care if you attend adult day care, but you would get the home care services in your home.

For more information about Medicare and Home Health Care, click here to open a brochure in a new window:

www.medicare.gov/publications/pubs/pdf/10050.pdf

For more information about qualifying for Medicaid in New York, click here to open a link in a new window:

www.health.state.ny.us/health_care/medicaid/#qualify

Private Health Insurance

Employer-sponsored health plans, long-term care insurance and managed care plans may cover home care services, including skilled nursing care, rehabilitation therapy or home health aide care.

Community Health Center works closely with most managed care insurances that provide a home care benefit.

Private Pay

Out-of-pocket payment may be an option for some home care services if Medicare/Medicaid or private insurance does not fully cover home health expenses.

Charitable Care

New York residents with no options for coverage or payment may receive charitable care.

If you are not sure whether you or your loved one would qualify for our services, you're not alone, it can be confusing, because each situation is different.

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