Does Medicare Cover Home Care? [How to Get Home Health Care Services]

Medicare home health eligibility requires ALL of these criteria: (1) the patient is under the care of a physician who certifies the need for home health services; (2) the patient is homebound — defined as having a condition that restricts the ability to leave home except with considerable difficulty, using assistive devices, or with another person's assistance; (3) the patient needs one or more skilled services: skilled nursing care, physical therapy, speech-language pathology, or occupational therapy (only when skilled nursing or therapy is also needed); (4) the home health agency is Medicare-certified. After foot surgery or with diabetic foot wounds, many patients meet all criteria. Balance Foot & Ankle in Howell (4330 E Grand River) and Bloomfield Township (43494 Woodward Ave #208) certifies eligible patients for home health — call (810) 206-1402.

Yes — Medicare patients have the right to choose any Medicare-certified home health agency willing to accept them. Hospitals and physicians may suggest agencies, but cannot require you to use a specific agency or limit your choice to a preferred network. Ask the referring physician or hospital discharge planner for a list of Medicare-certified agencies in your area, then evaluate based on quality ratings (Medicare's Home Health Compare website), specialization relevant to your needs (wound care, orthopedic recovery, dementia care), availability, and geographic coverage. Balance Foot & Ankle in Howell and Bloomfield Township works with multiple home health agencies to coordinate post-surgical and diabetic foot wound care — call (810) 206-1402.

During a skilled nursing home health visit for foot wound care: the nurse assesses the wound (size, depth, tissue type, drainage, signs of infection), performs prescribed wound cleaning and debridement, applies appropriate dressings, educates the patient and caregiver on wound care technique, assesses blood glucose for diabetic patients, reviews medications, documents findings for the physician, and coordinates with the podiatrist as needed. Skilled nursing visits typically last 45–90 minutes. The nurse coordinates care between the home health agency and your podiatrist. At Balance Foot & Ankle, we provide detailed wound care orders for home health nurses caring for our patients — call (810) 206-1402.

Medicare Part B covers some home medical equipment (HME) and supplies related to foot conditions: diabetic shoes and custom insoles (one pair per year with qualifying diagnosis), therapeutic footwear in some cases, wound care supplies when ordered as part of a home health plan of care (dressings, cleansers), and durable medical equipment (walkers, wheelchairs, hospital beds) when medically necessary. Supplies must be ordered by a physician and provided by a Medicare-enrolled supplier. The patient pays 20% of the Medicare-approved amount after the Part B deductible. Balance Foot & Ankle prescribes Medicare-covered diabetic shoes and orthotics for qualifying patients — call (810) 206-1402.

The Plan of Care (POC) — also called a 485 form — is the official Medicare document that specifies all home health services: diagnoses, clinical information, specific services ordered (nursing, PT, OT), frequency and duration of visits, medications, safety precautions, dietary instructions, and goals. The physician or qualified practitioner (including podiatrists for foot-related POCs) must sign and certify the POC, which is valid for a 60-day certification period. The home health agency develops the POC with physician input and implements it. Significant changes in patient condition require POC updates and physician approval. Balance Foot & Ankle in Howell (4330 E Grand River) and Bloomfield Township (43494 Woodward Ave #208) manages home health POCs for our foot care patients — call (810) 206-1402.