You need skilled care, part-time.
Skilled nursing, physical therapy or speech therapy, usually a few visits a week (occupational therapy can continue your care once home health has started).
Insurance and paperwork
Does Medicare cover home health care?
Yes, if you qualify: Original Medicare pays for covered home health visits, so you pay $0 for them. BREMA accepts Medicare and 28 other plans, including Medicare Advantage, commercial, military and workers' comp plans. Our intake team checks your benefits before the first visit and tells you what to expect.
We do not accept Medicaid or Medicaid managed care.
Plans we accept
Which insurance plans does BREMA accept?
BREMA accepts Medicare and these 28 plans. Don't see yours? Call intake at 214-339-9466.
Medicare
- Medicare
Medicare Advantage
- Aetna Medicare Advantage
- Amerigroup Medicare Advantage
- Anthem Medicare Advantage
- BSW Medicare Advantage
- Molina Medicare Advantage
- Superior Medicare Advantage
- UHC Medicare Advantage
- Wellcare Medicare Advantage
- Wellpoint Medicare Advantage
Other plans and payers
- Ambetter
- Carelon
- Cigna Commercial
- Curative Health Plan
- HOMELINK
- Humana
- Imperial Health
- Medicare MVA/MVC
- MTI America
- Oscar
- ProCare Advantage
- Provider Network of America
- Tango Care
- Tricare
- TriWest
- UHC Commercial
- Verdegard
- WellMed
- Workers' Comp
Medicare eligibility
How do you qualify for home health under Medicare?
Under Medicare, you qualify for home health when you need part-time skilled nursing, physical therapy or speech therapy, you are homebound, a doctor or other allowed provider has seen you and ordered the care, and a Medicare-certified agency, such as BREMA, provides it.
You are homebound.
Leaving home is hard for you. See below for what that means.
A provider has seen you and ordered it.
A doctor or other allowed provider sees you about this need and orders home health. This visit must happen within 90 days before or 30 days after home health starts, and it can be a telehealth visit.
A Medicare-certified agency provides it.
BREMA is Medicare-certified, CCN 747205.
Homebound, explained
What does homebound mean for Medicare?
Homebound means leaving home is hard for you because of an illness or injury. Medicare considers you homebound when both of these are true:
You need help to leave home
You need a cane, walker, wheelchair, special transportation or another person to leave, or your doctor advises you not to leave.
Leaving takes a lot of effort
You normally can't leave home, and leaving takes a considerable and taxing effort.
Is this homebound? A few examples.
- Home after hip surgery, uses a walker and needs to rest after a few steps: often, yes
- Has heart failure and gets short of breath walking to the mailbox: often, yes
- Needs a family member to drive and help them to every appointment: often, yes
- Drives to the store and runs errands most days: usually not
These are examples only. Your doctor decides whether you are homebound, based on your health.
What counts as skilled care?
Skilled care is care that must be given by, or supervised by, a licensed nurse or therapist. Examples include wound care, IV medicine, injections, checking an unstable condition, teaching you to manage a new diagnosis, and physical or speech therapy. Occupational therapy can continue your care once home health has started. Help only with bathing or chores is not skilled care.
What's covered
What does Medicare cover for home health care?
Medicare covers part-time skilled nursing, therapy, medical social services, home health aide visits alongside skilled care, and the supplies and equipment your care needs. It does not cover full-time care, or personal care and homemaker help when that is the only help you need.
What Medicare covers
- Part-time skilled nursing
- Physical and speech therapy, and occupational therapy once home health has started
- Medical social services
- Part-time home health aide visits, when you also get skilled care
- Medical supplies for use at home
- Durable medical equipment, such as a walker or wheelchair (20% coinsurance)
What Medicare doesn't cover
- Full-time or live-in care
- Meals delivered to your home
- Homemaker help, like shopping, cleaning and laundry, when it's not part of your care plan
- Personal care, like bathing or dressing, when that is the only help you need
How much does home health care cost with Medicare?
With Original Medicare, you pay $0 for covered home health visits. Medical equipment your doctor orders, such as a walker, usually costs 20% of the Medicare-approved amount after you meet the Part B deductible. Source: Medicare.gov (opens in a new tab).
How long will Medicare pay for home health care?
Medicare keeps paying for home health as long as you still qualify and your doctor orders the care; there is no set limit on visits. Care is planned in 60-day periods. Your doctor reviews your plan of care at least every 60 days and decides whether you still need skilled care. When you reach your goals, or no longer need skilled care, home health ends.
Does Medicare Advantage cover home health care?
Yes. Medicare Advantage plans cover home health care, but each plan sets its own rules. Many require you to use an in-network agency and to get approval before care starts, and some have copays. BREMA accepts Medicare and 28 other plans, including Medicare Advantage, commercial, military and workers' comp plans. The Medicare Advantage plans include Aetna Medicare Advantage, Amerigroup Medicare Advantage, Anthem Medicare Advantage, BSW Medicare Advantage, Molina Medicare Advantage, Superior Medicare Advantage, UHC Medicare Advantage, Wellcare Medicare Advantage and Wellpoint Medicare Advantage.
What if I have another kind of insurance?
We also accept several commercial, military and workers' compensation plans, including Cigna Commercial, Oscar, Tricare, TriWest and workers' comp. We do not accept Medicaid or Medicaid managed care plans. If you have Medicaid, call us and we'll point you toward options.
Will I get a bill?
Before your first visit, our intake team checks your benefits and tells you about any costs you might have. If something changes during your care, we tell you before it affects your bill.
Can I choose my home health agency?
Yes. Under Medicare, you can choose any Medicare-certified home health agency that serves your area, including BREMA. If you are leaving the hospital, the hospital must give you a list of home health agencies that serve your area, and you can also compare agencies on Medicare Care Compare (opens in a new tab). See how to ask for BREMA.
Common questions
Questions about coverage
Is there a copay for home health under Original Medicare?
No. Under Original Medicare, you pay $0 for covered home health visits. You may pay 20% of the Medicare-approved amount for medical equipment after the Part B deductible.
Is there a limit on how many home health visits Medicare covers?
There is no set limit as long as you keep qualifying and your doctor orders the care. Your doctor reviews your plan of care at least every 60 days.
Do I have to be in the hospital first to get home health?
No. Medicare does not require a hospital stay before home health. If you meet the rules and your doctor orders it, you can start home health from home.
Can I get home health in assisted living?
Yes. Medicare covers home health wherever you live, including an assisted living community, as long as you qualify. It does not cover home health while you are in a hospital or skilled nursing facility.
Do I need a Medicare supplement (Medigap) for home health?
Not for covered home health visits, which cost $0 under Original Medicare. A Medigap policy may help pay the 20% coinsurance for medical equipment.
Does BREMA accept Medicaid?
No. BREMA does not accept Medicaid or Medicaid managed care plans. We accept Medicare and 28 other plans, including Medicare Advantage, commercial, military and workers' comp plans.
Does BREMA take Tricare and workers' comp?
Yes. BREMA accepts Tricare, TriWest and workers' compensation, along with Medicare and several commercial plans.
Questions about your plan?
Call intake Monday–Friday, 8 a.m.–5 p.m. We'll check your benefits and tell you what to expect. You can choose any Medicare-certified home health agency that serves your area, including BREMA.
Case managers: make a referralSources: Medicare.gov, Home health services (opens in a new tab); CMS Medicare Learning Network, Home health services compliance tips (opens in a new tab)