Do you qualify for home health?
Home health is a clinical benefit, not a service you can simply buy into. Four things have to line up.
1. A physician’s order and a plan of care
Home health begins with an order from your physician or another authorized practitioner, who signs a plan of care setting out what is to be done and how often. Nothing starts without it, and the plan is reviewed and re-signed at intervals while care continues.
2. A skilled need
The care has to be something that legally requires a nurse or a licensed therapist — wound care, IV therapy, injections, rehabilitation, swallowing assessment. Help with bathing and meals is real and important, but on its own it is not a skilled need, and it is the most common reason a home health referral is declined.
If daily personal care is the actual need, the Consumer Directed Services program is usually the better route. CDS eligibility →
3. Coverage
We accept MO HealthNet, private insurance, and private pay. Each payer sets its own rules about what is covered, how often, and for how long. We do not currently accept Medicare as payment for home health, even though the agency is Medicare-certified — if Medicare is your only home health coverage, say so on the first call.
4. A home we can reach
St. Louis City, St. Louis County, and Missouri communities within roughly 40 miles of our office on Woodson Road. Missouri only.
What does not disqualify you
- Living with family. Having capable relatives at home does not remove a skilled need.
- Already having a CDS attendant. The two services can run at the same time and often should.
- Being able to leave the house sometimes. Even where a payer applies a homebound rule, it does not mean confined to bed — leaving for medical appointments, religious services and short outings is generally contemplated.
- Age. Home health is not only for older adults.
If you are not sure
Call us and describe what is actually happening. We will tell you honestly whether it sounds like a skilled need, whether home health is the right benefit, or whether something else fits better — including saying so when the answer is no.
Need skilled care at home?
Call (314) 809-6655, or text (314) 886-5902. Home health starts with an order from your physician — we can talk you through how to get one.