Physician orders
A doctor must order home health services and stay involved in the plan of care.
Medicare & Coverage
Medicare home health, explained simply
Medicare may cover home health services when care is medically necessary, ordered by a physician, and home health eligibility requirements are met.
We'll explain how it works and help you understand what to expect — no pressure, just clear answers.
- Medicare-Certified
- AHCCCS Provider
- Plain-Language Help
- Greater Phoenix
How Medicare home health coverage works
Coverage is determined by Medicare based on the individual's situation. The information on this page is general and educational. We do not promise guaranteed coverage or $0 cost for everyone — call us and we'll explain in plain language.
What Medicare looks at
Common requirements for home health coverage
Medicare reviews each situation individually. These are the most common factors patients and families ask us about.
Medical necessity
Care must be medically necessary — skilled nursing or therapy, not long-term custodial care.
Homebound status
The patient must meet Medicare's homebound criteria: leaving home requires considerable effort.
Skilled need
Skilled nursing, physical therapy, occupational therapy, or speech therapy ordered as needed.
Approved plan of care
An individualized plan of care signed by the physician, reviewed regularly.
Face-to-face encounter
A qualifying visit with the certifying provider that documents the need for home health.
What Saintly helps with
We help you understand your coverage
Our intake team will review your situation, explain how Medicare home health coverage works for your plan, and coordinate with your physician for the documentation Medicare requires.
- Confirm whether home health is appropriate for the patient
- Coordinate physician orders and the face-to-face encounter
- Walk through what a plan of care includes
- Explain what to expect from a typical home health episode
Plans & coverage types
How different plans typically work
Original Medicare (Part A / Part B)
When eligibility criteria are met, Medicare may cover approved home health visits at 100% — no copay for covered services.
Medicare Supplement (Medigap)
Many supplements help with any costs that Original Medicare does not cover, which can mean little to no out-of-pocket cost for covered care.
Medicare Advantage (Part C)
Coverage rules and provider networks vary by plan. We'll help review your plan and explain what we can accept today.
AHCCCS (Arizona Medicaid)
Saintly Home Health is an AHCCCS provider for qualifying patients — call us and we'll help confirm eligibility.
Not sure what your plan covers?
Call our intake team — we'll review what your plan typically allows and what we can accept today.
FAQ
Common Medicare questions
Does Medicare always cover home health?
Not always. Medicare may cover home health when care is medically necessary, ordered by a physician, and the patient meets home health eligibility requirements (including homebound status and a skilled need). Coverage is determined by Medicare based on the individual's situation.
Will I have a copay?
For Original Medicare patients who meet home health requirements, approved home health visits are typically covered at 100% with no copay for covered services. Costs may apply for items outside the home health benefit (for example, durable medical equipment may have separate cost sharing).
What does "homebound" mean?
Homebound generally means leaving home requires a considerable and taxing effort, typically with the help of supportive devices, special transportation, or another person. Patients can still leave home occasionally for medical care, religious services, or short events.
Do I need a doctor's order to start home health?
Yes. Medicare home health requires a physician/provider order and a face-to-face encounter that documents the need for skilled care at home. Saintly Home Health can help coordinate this with your provider.
Can Saintly help me confirm what my plan covers?
Yes — call our intake team in Tempe and we'll walk you through the basics of how Medicare home health coverage works, what your plan may allow, and the next steps in plain language.
Talk to a real person
Have Medicare questions? We'll explain it in plain language.
Call our intake team in Tempe and we'll review what your plan typically allows and what to expect.