Seniors recovering from an illness, accident or surgery under the care of a physician may qualify for home health care financial assistance in Utah. Home health care is intended to help individuals return to a stable condition after hospitalization. Short-term health care visits by medical professionals, including certified home health aides, therapists or nurses as prescribed by a doctor are usually eligible for financial assistance, depending on insurance coverage. 

What Insurance Options Cover Home Health Care?

Utah’s Medicaid program offers home health care financial assistance for those who meet financial and medical requirements. There are several waiver programs to choose from based on an individual’s preferences and level of care. The Aging Home and Community Based Waiver provides coverage for adults aged 65 and older to receive medical services in multiple settings, including their own home. The Aging Waiver can also be used for home health care services by older adults requiring a nursing facility level of care. 

Medicare provides financial assistance for certain home health care services. To be eligible for Medicare coverage, an individual must be:

  • Under the care of a doctor and receiving services according to an approved care plan
  • Certified by a doctor as meeting certain requirements, such as needing intermittent skilled nursing care or therapy services
  • Verified by a doctor as being homebound

Adults are only eligible for home health care Medicare coverage as long as the physician and home health care agency certifies regular at-home medical services are needed for recovery. Veterans may also be eligible for health benefits through the Department of Veterans Affairs (VA), which includes home health care. Many private health insurance options provide coverage for short-term home health care, although a co-payment may be required. 

What Home Health Care Services Are Covered by Financial Assistance in Utah?

The exact home health care services eligible for financial assistance will vary depending on the insurance option. To receive Medicaid or Medicare assistance, home health agencies must meet certain standards established by the Centers for Medicare & Medicaid Services (CMS). Eligible home health care services typically include:

  • Intermittent skilled nursing care
  • Physical, occupational and speech therapy
  • Medical social services
  • Medical equipment
  • Medical supplies for home use 
  • Injectable osteoporosis drugs for women

Home health care agencies usually coordinate with an individual’s doctor to administer the necessary services. There are also some services that may not be eligible for financial assistance, including around-the-clock home supervision, meal delivery and homemaker or personal care tasks unrelated to an individual’s care plan.