Eligibility & Payment Options

Medicare will pay for an unlimited number of visits provided the following criteria are met on a continuous basis. Medicaid criteria vary from state to state (Virginia dictates a specific number of visits / discipline each year).

Eligibility for Medicare or Medicaid or Private Insurance

Who is covered?

• Persons 65 years of age or older who have contributed to the Social Security Program.
• Persons under 65 years of age who have received state disability benefits for two years.
• Persons under 65 years of age who have a chronic renal disease (end stage) for three months.

US citizens are eligible for Medicare benefits after the age of 65.

The Client must need one of the following skilled services before they can be considered for additional services offered under the Medicare/Medicaid programs:

• Skilled Nursing - this service must be of a nature that would be unsafe and ineffective unless performed by a Registered Nurse (RN) or a Licensed Practical Nurse (LPN) under the supervision of an RN.
• Physical Therapy or Speech Therapy - rehabilitation services must be of such a level of complexity and sophistication, or the condition of the patient must be of a nature that the required services would be unsafe and ineffective unless performed by a qualified Therapist. There must be an expectation that the patient's condition will improve significantly in a reasonable and generally predictable period of time.

Physician's Orders

Home health care patients must be currently under the care of a Physician. AT Home Care will contact your physician to secure signed medical orders and a plan of care (POC) appropriate to your individual needs.

Reasonable and Medically Necessary

Items or services must be reasonable and necessary for the diagnosis or treatment of the illness or injury or to improve the functioning of the individual being considered for services.

Homebound

Synonymous with confined primarily to the home as a result of medical reasons, the term connotes that it is a "considerable and taxing effort" to leave the home.

Click here to learn more about the insurance plans we accept >