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Who Pays For Home Care

Who Pays For Home Care?

Medicare and Medicaid (Mass Health) Coverage

Home care services are usually paid for by Medicare, Medicaid or private insurance. There are certain medical and eligibility requirements that need to be met before Medicare or other insurance companies will authorize care.

In order to qualify for home care coverage under Medicare, a patient must:

  • Be homebound
  • Be under the care of a physician
  • Require skilled nursing services, physical therapy, occupational therapy or speech therapy on an intermittent (part-time) basis
  • Reside in a home or facility that does not perform skilled care (in other words, the patient must not be located in a nursing home  or hospital

Commercial Insurance Coverage

Most insurance companies base their level of home care coverage on the Medicare guidelines, and require that services be authorized prior to coverage. The Berkshire VNA is a contracted provider for home health services - to find out more call the reimbursement department at 1-800-788-2862.

Our staff will work with you and your insurance company to coordinate benefits. If you are uninsured, or if you believe your insurance and/or income will not cover the cost of your care, of if there is a change in your insurance, you may qualify for financial assistance. Berkshire VNA has a financial assistance policy for low-income uninsured patients who may not be able to pay for services. For information about our charity care policy that provides for full or partial assistance, please contact the Berkshire VNA .

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