Because Somerset Home Health Care maintains Medicare certification, Medicare pay 100% of allowable charges from Somerset. However, to qualify for our home health services, Medicare has certain rules. Most insurance companies use qualification rules similar to Medicare's. We summarize these rules below, but if you are unsure about whether you qualify, please simply call or email us.

Homebound
Patients receiving insurance-reimbursed home health should meet the definition of homebound. This does not mean that a person cannot leave the home. Medicare's definition of homebound simply states that, during the episode of care, leaving the home would require a considerable and taxing effort. Because of this, trips from the home are infrequent and of short duration. People can be homebound temporarily while recovering from injury or illness.

Skilled Need
The skilled need requirement means that the plan of care must call for the services of a nurse or therapist. This is meant to rule out plans of care that only call for personal care assistance that could be accomplished by a home health aide. For instance, any plan of care that only calls for help with bathing and getting dressed would not meet the skilled need requirement. Plans of care that call for rehabilitation, wound care, medication teaching, observation and assessment, and other skilled activities that are outside the scope of a home health aide meet the skilled need requirement. This being said, as long as the skilled need requirement is met, Somerset Home Health Care can provide personal care assistance as well. We are just not allowed to only provide personal care assistance.

Physician Supervision
Home health plans of care must be signed by your doctor (MD, DO, or DPM). Somerset Home Health Care does not try to convince patients to switch doctors or use new doctors. We recognize, support, and encourage your relationship with your doctors. That's why Somerset is committed to collaborating with your doctors on a home health plan of care and following orders from the doctor you know and trust.

A home health patient must have seen his or her doctor within 90 days before or 30 days after the home health start of care. Somerset Home Health Care will work directly with your doctor and do all the work of getting the necessary paperwork. Somerset also works hard to keep your doctor in the loop with relevant information so he or she can effectively track your progress.