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EDWARD Hospital and Health Services


Medicare and Your Eligibility

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When ordered by a patient’s physician, skilled services covered by Medicare include:

  • Registered Nurse
  • Physical Therapy
  • Speech Therapy

Additional services such as Occupational Therapy, Medical Social Worker, Registered Dietician, Wound Certified Nurse and Home Health Aide may accompany skilled service to provide a clinical approach to achieve self-management.
Getting treatment from a home health agency that is Medicare-certified can reduce your out-of-pocket costs. Medicare covers 100% of eligible home health services.

Here are some specific criteria that must be met in order to be eligible for home health care under Medicare:

  • Home health care and a skilled service are ordered by a physician
  • The patient is ‘homebound’ (can’t leave the home unassisted or leaving the home isn’t recommended because of a patient’s condition); the patient can still leave the home for medical treatment or short, infrequent absences for non-medical reasons such as attending religious services
  • The home health care agency is Medicare-certified

Once all eligibility requirements are met, Medicare covers medically-necessary services on an intermittent basis (a few hours a week). Learn more about eligibility requirements for Medicare coverage of home care services

We’ve created a guide for patients and caregivers to help ensure you choose the right home health agency for you or your loved one. We’ve included answers to questions recommended by the Centers for Medicare and Medicaid to support an informed decision-making process.

Residential Home Health has Home Care Specialists available at 866-902-4000 to answer any questions regarding Medicare coverage and Residential’s home care options.

What other insurances does Residential Home Health accept?

We accept:

  • Medicare
  • Medicaid
  • BCBS
  • BCBS medical groups for Dupage Medical IHP (Illinois Health Partners) 
  • Aetna
  • Humana (for Edward hospital)
  • United Health Care
  • A variety of other commercial payors

If you have questions regarding your specific coverage, please call us at (866) 902-4000.

What isn’t covered?

Below are some examples of what Medicare doesn’t pay for:

  • 24-hour-a-day care at home
  • Meals delivered to your home
  • Homemaker services like shopping, cleaning, and laundry when this is the only care you need, and when these services aren’t related to your plan of care
  • Personal care given by home health aides like bathing, dressing, and using the bathroom when this is the only care you need.

Medicare only covers services provided by the home health agency. Other medical services, such as visits to your doctor, may still be covered by your other Medicare benefits. Visit http://go.usa.gov/iDJ to view or print out a copy of the “Medicare & You” handbook.

Questions about your Medicare benefits?

If you have questions about your Medicare benefits, you should call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.




 

(630) 527-3000

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Edward Hospital & Health Services
801 S. Washington, Naperville, IL 60540 • (630) 527-3000

Naperville • Plainfield • Bolingbrook • Oswego • Woodridge
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