Medicare will pay for

• A. All care requested by recipient
• B. All care requested by doctor
• C. All care requested by the home health agency
• D. Only care that is determined to be medically necessary

Answer: (D)

Medicare coverage for home health care is limited to services that are medically necessary and included in an approved plan of care ordered by a physician. The patient must be homebound, and the care must be required to treat a specific illness or condition with skilled services (such as nursing or therapy). Non-medical or custodial care, or services not determined to be medically necessary, are not covered. The home health agency must provide services under the physician’s orders and the documented plan of care. So Medicare pays only for care that is medically necessary and part of an approved plan of care; it does not pay for everything requested by the patient, the doctor, or the agency.