Keeping up with doctor’s appointments is essential to managing health and staying informed, but it can often feel overwhelming. From scheduling and transportation to understanding medical advice and ensuring proper follow-up, there are many details to manage. This is where Understood Care can help. Our advocates serve as trusted guides, working alongside you or your loved one to make the process easier, more organized, and more comfortable.
Personalized Support Before and After Every Appointment
Understood Care advocates provide hands-on help with all aspects of medical visits. We help you schedule appointments, confirm provider information, and prepare for the visit itself. This might include reviewing your questions ahead of time, making sure prescriptions are current, or gathering any medical records needed. After the appointment, we help you understand the doctor’s recommendations and take the right steps to follow through on care instructions, referrals, or additional tests.
A Partner to Help You Understand Your Care
Medical visits can involve unfamiliar language, new diagnoses, or complex treatment plans. Your advocate is there to help translate this information into clear, understandable terms. We make sure you feel confident about what was discussed during the visit and that you know what actions to take next. If something is unclear or left unanswered, your advocate can follow up with your provider to get the information you need.
Coordination Across Your Care Team
Many people receive care from more than one doctor. Your advocate helps ensure that your care is well coordinated across primary care providers, specialists, and other professionals. We help share information between offices, keep records consistent, and make sure appointments align with your overall care goals. This reduces confusion and helps prevent important details from being overlooked.
Support for Getting to and From the Appointment
Transportation should never be the reason you miss a doctor’s visit. Your advocate helps you arrange reliable ways to get to and from appointments. Whether that means booking a ride service, coordinating with a caregiver, or finding community transportation resources, we make sure you have safe and timely access to care. We also consider mobility needs, language assistance, and other accessibility factors to support your comfort and safety.
Emotional and Practical Support Throughout
Doctor’s visits can bring up feelings of stress, uncertainty, or fatigue, especially when managing long-term conditions or complex health needs. Understood Care advocates are here to offer steady support throughout the experience. We are here to listen, provide encouragement, and help you make informed decisions without feeling overwhelmed.
Confidence in Every Step of the Journey
With Understood Care, you are never alone in managing your medical appointments. From the moment you schedule your visit to the follow-up that comes afterward, your advocate is there to help you stay organized, prepared, and empowered. We make it easier to stay connected to the care you need and to move forward with confidence.
What this guide covers
If you are asking how home care works or whether Medicare pays for it, you are not alone. In our video, Amanda at Understood Care explains the practical steps. If you need dressing changes, help organizing and understanding medicines, or therapy at home, your clinician can write an order to start home health. A Medicare certified home health agency then provides your care and bills Medicare. There are a few important rules, including having a qualifying skilled need and meeting homebound criteria. This article translates the rules into clear steps, shows what is covered, and points you to resources that make care at home safer and easier.
You will also find direct help from Understood Care when you need mobility equipment, safer home setups, transportation to appointments, or a dedicated advocate to coordinate the details
- Mobility equipment support https://understoodcare.com/care-types/mobility-equipment
- Home safety and accessibility tips https://understoodcare.com/care-types/home-care
- Transportation help https://understoodcare.com/transportation-help
- What healthcare advocates do https://understoodcare.com/advocates
Home care versus home health care
Home care is a broad term. It can include non medical help with bathing, dressing, meals, and light housekeeping. Home health care is medical care delivered at home by licensed clinicians and therapists under a care plan. Medicare covers home health care when you qualify. Medicare does not pay for ongoing non medical companion services when that is the only help you need.
The video summary in plain language
Amanda’s message reflects what many of you experience. If you need wound dressing changes, teaching and setup for medications, or therapy such as physical therapy or occupational therapy, your primary care clinician can order home health. A nurse practitioner or physician assistant can be involved too. The agency comes to you and bills Medicare when the requirements are met. Most agencies also ask that you meet homebound criteria. Brief trips out of the house for medical care are expected, and short infrequent nonmedical absences like attending religious services are compatible with homebound status. Check details with your clinician and agency.
Who qualifies for Medicare covered home health
To qualify you need all of the following
- A part time or intermittent need for skilled nursing or for therapy services
- Homebound status as defined by Medicare
- An order and care plan from a clinician and services provided by a Medicare certified home health agency
- A face to face visit with a clinician around the start of care
Medicare defines homebound to mean that you have trouble leaving home without help because of illness or injury, that leaving is not recommended, or that leaving takes major effort. You may leave home for medical treatment or for short infrequent nonmedical reasons such as attending religious services.
Before certifying home health, a clinician must see you face to face. By rule, the encounter must occur within the 90 days before or the 30 days after home health starts and must document why you are homebound and need skilled services.
What Medicare covers at home
Medicare covers these home health services when you qualify
- Skilled nursing on a part time or intermittent basis including wound care, injections, IV or nutrition therapy, monitoring unstable health, and patient and caregiver teaching
- Physical therapy, occupational therapy, and speech language pathology services when medically necessary
- Medical social work services to address social and emotional needs related to recovery
- Part time or intermittent home health aide services when you are also receiving skilled nursing or therapy from the agency at the same time
- Certain osteoporosis injections when criteria are met
- Durable medical equipment and medical supplies used at home as ordered
In most cases part time or intermittent means up to eight hours per day combined nursing and aide services for a maximum of 28 hours per week, with limited situations up to 35 hours per week when your clinician decides it is necessary.
The Medicare Home Health booklet describes how agencies work with you and your clinician to create and review the plan of care, what skilled therapy requires, and how aide and social work services are added when you are already receiving skilled care.
What Medicare does not cover at home
Medicare does not cover
- Twenty four hour care at home
- Home delivered meals unrelated to your plan of care
- Homemaker services like shopping or cleaning when these are the only services you need
- Custodial personal care on its own when you do not also need a skilled service
These limits are important when planning. If you only need help with daily activities, you can look for community and family supports, local programs, and long term care options.
What you pay
You pay zero for covered home health services. After you meet the Part B deductible, you pay twenty percent of the Medicare approved amount for covered durable medical equipment such as a walker or wheelchair. Agencies must tell you in writing if Medicare is unlikely to pay for an item or service and should give you an Advance Beneficiary Notice before providing it.
For mobility equipment support and safe setup at home, our team can help you understand options and coverage
https://understoodcare.com/care-types/mobility-equipment
How to get started step by step
- Talk with your clinician. Share the home tasks you are struggling with such as wound care, new medicines, or walking safety. Ask if you qualify for home health.
- Complete the face to face visit and get an order. Your clinician or an allowed practitioner documents your skilled need and homebound status.
- Choose a Medicare certified home health agency. Your clinician should offer a list of agencies that serve your area. You have a say in which agency you use.
- Meet the home health team. They will review your needs, coordinate with your clinician, and start the care plan. Services may include nursing, therapy, an aide, and social work as needed.
- Ask about hours, supplies, and equipment. Confirm what is covered, what requires coinsurance, and how to reach your team between visits.
If transportation to medical visits is a barrier, see
https://understoodcare.com/care-types/transportation-help
Safety and success at home
Infection prevention basics
Home health agencies follow core infection prevention practices and teach patients and caregivers how to protect themselves. Wash hands before and after care, clean and store supplies as taught, and follow instructions for wound care and catheters.
Caregiver teaching is part of the plan
During Medicare home health, clinicians often train family caregivers to support safe care between visits. Research shows caregiver instruction helps with discharge timing and reduces risks when combined with clear communication and written plans.
Keep mobility and balance in focus
Therapy at home builds strength and balance so you can move more safely. Ask about simple home exercises and environmental adjustments. For practical home safety ideas, visit
https://understoodcare.com/care-types/home-care
How Understood Care can help
Our advocates can
- Coordinate with your clinician to request an order and align your plan of care
- Help you compare home health agencies and prepare questions for the intake nurse
- Arrange transportation to follow up visits and community services
- Assist with equipment choices and insurance steps
Start here to meet with an advocate
https://app.understoodcare.com/
Learn about advocate support
https://understoodcare.com/advocates
Frequently asked questions
What is the difference between home health and non medical home care
Home health is medical care delivered at home by licensed clinicians and therapists under a care plan when you meet Medicare rules. Non medical home care is help with daily activities and companionship. Medicare covers home health when you qualify. Medicare does not pay for ongoing companion or housekeeping services when those are the only services you need.
Do I have to stay inside all the time to be homebound
No. Medicare allows you to leave home for medical treatment and for short infrequent nonmedical absences such as attending religious services. You must still meet the overall standard that leaving home requires considerable effort or is not recommended.
How many hours can I get
Home health services are part time or intermittent. In most cases that means up to eight hours a day with a weekly total of twenty eight hours for nursing and aide services combined, with short term increases up to thirty five hours when your clinician decides it is necessary.
Who can order home health and what is the face to face requirement
A clinician must order your care and complete a face to face encounter around the start of care. The visit must occur within the ninety days before or thirty days after home health starts and must document why you are homebound and need skilled services.
What do I pay
You pay zero for covered home health services. After the Part B deductible, you pay twenty percent of the Medicare approved amount for covered durable medical equipment such as walkers and wheelchairs.
Can I get an aide if I only need help with bathing and dressing
Medicare covers home health aide services only when you are also receiving skilled nursing or therapy from the agency at the same time. If you only need help with daily activities, look into community programs and long term care options in your area.
Can I receive nursing and therapy at the same time
Yes. When you qualify, the plan of care can include skilled nursing and one or more therapy disciplines based on your needs. The agency coordinates services with your clinician.
How do Medicare Advantage plans handle home health
Medicare Advantage must cover at least what Original Medicare covers but plans can have network and authorization rules. Check your plan details and ask the agency to verify coverage before care starts.
How is equipment covered when I start home health
Durable medical equipment is paid separately from the home health visit cost structure. You usually owe twenty percent of the Medicare approved amount after the Part B deductible. Your clinician must order the equipment, and the agency can help coordinate delivery.
Can I switch agencies if the fit is not right
You have rights during home health, including the ability to choose an agency and to speak up about quality concerns. Ask your clinician for help if you need to change.
References
- Medicare.gov Home health services coverage
https://www.medicare.gov/coverage/home-health-services - Medicare and Home Health Care booklet CMS Product No 10969
https://www.medicare.gov/publications/10969-medicare-and-home-health-care.pdf - Medicare’s Home Health Benefit CMS Product No 11357
https://www.medicare.gov/publications/11357-home-health-getting-started.pdf - CMS Home health face to face encounter guidance
https://www.cms.gov/files/document/may-20-2014-home-health-face-face-special-open-door-forum-presentation-508-cleanpdf - National Institute on Aging Services for Older Adults Living at Home
https://www.nia.nih.gov/health/caregiving/services-older-adults-living-home - CDC Core Infection Prevention and Control Practices for Healthcare Delivery
https://www.cdc.gov/infection-control/hcp/core-practices/index.html - CDC Standard Precautions for All Patient Care
https://www.cdc.gov/infection-control/hcp/basics/standard-precautions.html - Caregiver training in home health research articles
https://pmc.ncbi.nlm.nih.gov/articles/PMC8742751
https://pmc.ncbi.nlm.nih.gov/articles/PMC9106880
This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.
Deborah Hall
- About: Deborah Hall’s primary specialty is other healthcare benefits access. She helps people apply for coverage, clears questions, and connects them to programs fast.
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