Services under Medicare

Medicare recipients must meet the following criteria:

A. Homebound Status: For Medicare Part A and Part B recipients, a physician must certify in all cases that the client is confined to the client's home. An individual does not have to be bedridden to be considered for services under the program. However, the condition of the client should be such that there exists a normal inability to leave home and, consequently, leaving home would require a considerable and challenging effort. In fact, should the client leave home, the client may nevertheless be considered homebound if the absences from home are infrequent or for periods of relatively short duration, or are associated with a need for the client to receive health care treatment, or for some personal needs (Hair Salon, walk around the block, a scenic drive etc.), and family or social events (reunion, funeral, graduation, etc.)

Furthermore, a client's "Homebound Status" is still in effect even if the client attends religious services, or attends a Medical Adult Day Care Center which is licensed, certified, or accredited by the State.

B. Be under the care of a physician: Under the direction of the client's physician's signed and established care plan, skilled providers, such as registered nurses, physical therapists, medical social workers, and home health aides visit the client's home to implement the plan.

C. Require Skilled Services: Skilled Services are those services that are medically reasonable and necessary for the treatment of the client's illness or injury. Skilled nursing care is on a part-time or intermittent basis.

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