Patient Eligibility
At Icon home. we accept the following coverages on a case by case basis. All Private and Managed Care Insurances require prior authorization / pre-certification. If you are unsure whether the client is eligible for home health services, please don’t hesitate to call us at 713 436 8400.
- Medicare
- Group Health Insurance Plans
- Private Pay
- Private Health Insurance Plans.
Medicare Home Health Benefits Eligibility
The following is an excerpt from the booklet published by Medicare called Medicare and Home Health Care that explains the rules for Medicare Home Health Care eligibility and covered services.
- You must be under the care of a doctor, and you must be getting services under a plan of care established and reviewed regularly by a doctor.
- You must need, and a doctor must certify that you need, one or more of the following.
- Intermittent skilled nursing care
- Physical therapy
- Speech-language pathology services
- Occupational therapy
- The home health agency caring for you must be approved by Medicare (Icon home. is Medicare-certified).
- You must be homebound, and a doctor must certify that you’re homebound. To be homebound means the following:
- 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.
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Home Health Care is skilled medical care provided in the patient place of residence for the treatment of an illness of injury.
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