There must be a need for skilled care services, and the individual must be essentially home bound. There is no requirement for a prior hospital stay in order to receive home health benefits. A home health agency can be of assistance in determining if the patient's health care needs meet the criteria for Medicare of Medicaid reimbursement. Some agencies have a sliding fee schedule for those individuals without insurance coverage. A physician participating in the Kentucky Physician Care Program may refer someone to home health through this network.
Coverage varies widely.
Insurance plans may cover expanded services beyond specific identified benefits if such services are cost effective and medically appropriate alternatives to institutional care. A special Medicaid program called Home and Community Based Waiver Program provides supportive care in the home for those Medicaid recipients who are eligible for care in a nursing facility. The services are ordinarily not covered under Medicaid's traditional home health care. Special income and eligibility requirements must be met. Any home health care agency providing these services can explain requirements and assess whether the patient's needs qualify them for these services.