Paying for home health care

Paying for home health

Home health with Communicare Elite is paid for through MO HealthNet, private insurance or private pay. The agency is Medicare-certified but does not currently accept Medicare as payment for home health.

Coverage is verified before care begins, not after. Nobody should discover what they owe from a bill.

What insurance covers home health care?

Payer	How it works
MO HealthNet (Missouri Medicaid)	Home health is a covered MO HealthNet benefit with a physician’s order. Coverage rules and limits are set by the program, not by us.
Private insurance	Most plans cover home health with an order and, frequently, prior authorization. We verify your specific benefits — coverage, visit limits, and any copay or deductible — before care starts.
Private pay	Self-funded, for people without coverage or who want services beyond what a payer authorizes.

Does Communicare Elite accept Medicare for home health?

Communicare Elite is a Medicare-certified home health agency. Certification means the agency has been surveyed against the federal Conditions of Participation — the standards CMS sets for how a home health agency must operate, document care, and protect patients. It is a statement about the standard of the agency.

What gets checked before home health care starts?

1. That your coverage is active.
2. Whether prior authorization is required, and obtaining it if so.
3. Which services are covered, and any visit limits.
4. What you would owe, if anything.
5. Whether the physician’s order and plan of care are complete.

If something is not covered, you hear it from us in advance — including when the honest answer is that a service you want is not going to be paid for.

What if home health coverage is denied?

Denials are not always final. Ask for the reason in writing, since many are administrative rather than clinical — a missing order, an authorization that lapsed, a coding error. Those get fixed and resubmitted. Where a denial is genuinely clinical, you have appeal rights through your payer, and your physician’s supporting documentation carries real weight.

Grievances and appeals →

What if home health is not covered but you still need help?

For MO HealthNet participants, the Consumer Directed Services program covers long-term personal care and costs the participant nothing. It does not cover skilled clinical care — but for people whose real need is daily help rather than nursing, it is frequently the better answer.

CDS eligibility →

Frequently asked questions

Does MO HealthNet cover home health care?

Yes. Home health is a covered MO HealthNet benefit when your physician orders it. The program, not the agency, sets the coverage rules and limits. We confirm your coverage is active, check which services and how many visits are covered, and tell you what you would owe, if anything, before the first visit.

Do I need prior authorization for home health?

Often, yes, with private insurance. Most plans cover home health with a physician’s order, and many also require prior authorization. We check whether your plan needs it and obtain it before care starts. An approval is not a promise of payment, so we also verify your benefits, visit limits and any copay or deductible.

Why doesn’t Communicare Elite list home health prices?

Because the cost depends on the service, how often visits happen and what your coverage pays, and a number posted on a website goes stale and misleads. Call (314) 809-6655 and we will give you real figures for your situation, before care begins, so nobody learns what they owe from a bill.

How do I start home health care?

Home health starts with an order from your physician. If you do not have one yet, call or text us and we will talk you through how to get it. Once the order is in, we verify your coverage and make sure the physician’s order and plan of care are complete before the first visit.