As a Chicago senior, understanding your Medicare home health benefits can help you access the care you need without unnecessary financial stress. At HomeHealth, Inc., we’re here to help you navigate these benefits and receive quality care in the comfort of your own home.
What Is Medicare Home Health Care?
Medicare home health care provides skilled medical services to eligible beneficiaries who are homebound or have difficulty leaving their homes. These services help you recover from illness, manage chronic conditions, or maintain independence after surgery or hospitalization—all without leaving the comfort and familiarity of home.
Medicare Eligibility for Home Health Care
To qualify for Medicare-covered home health care, you must meet specific requirements:
Basic Eligibility Requirements
- Medicare Enrollment – You must be enrolled in Medicare Part A and/or Part B.
- Physician’s Order – Your doctor must certify that you need home health care and create a plan of care. This is essential—no home health services can begin without a physician’s order.
- Homebound Status – You must have difficulty leaving your home without assistance, or leaving home requires considerable and taxing effort. This doesn’t mean you’re confined to home—you can still attend medical appointments, religious services, or occasional family outings.
- Medical Necessity – You must need skilled medical services on an intermittent basis. This isn’t about wanting help—it’s about your medical condition requiring professional care.
- Medicare-Certified Agency – Services must be provided by a Medicare-certified home health agency. At HomeHealth, Inc. is fully Medicare-certified and serving the Chicago area.
What “Homebound” Really Means
Many seniors worry that being classified as homebound means they can never leave home. This isn’t true! You’re considered homebound if:
- Leaving home requires considerable and taxing effort
- You need assistance (walker, wheelchair, or another person) to leave home
- You don’t leave home except for medical appointments, religious services, or occasional family outings You can still attend your grandson’s graduation, go to church on Sunday, or visit your doctor—these activities don’t disqualify you from home health care.
What Medicare Covers
Medicare covers a range of skilled home health services when they’re medically necessary:
Skilled Nursing Services
Medicare Part A covers skilled nursing services when they’re related to your qualifying hospital stay (within 100 days). Medicare Part B covers skilled nursing for other medical conditions.
Skilled nursing services include:
- Wound care and dressing changes
- Injection administration
- Intravenous (IV) therapy
- Medication management and education
- Vital sign monitoring
- Diabetes management
- Post-surgical care
Physical Therapy
Medicare Part B covers physical therapy when it’s medically necessary. Services include:
- Gait training and walking exercises
- Balance and fall prevention training
- Strength building exercises
- Transfer training (moving from bed to chair, etc.)
- Pain management techniques
- Mobility improvement after surgery or injury
Occupational Therapy
Also covered under Medicare Part B, occupational therapy helps you:
- Relearn daily living skills (bathing, dressing, eating)
- Improve fine motor skills
- Learn to use adaptive equipment
- Modify your home for safety
- Develop energy conservation techniques
- Manage activities of daily living independently
Speech Therapy
Medicare Part B covers speech-language pathology services for:
- Communication disorders
- Swallowing difficulties (dysphagia)
- Cognitive-communication issues
- Memory and language exercises
- Voice disorders
- Aphasia treatment after stroke
Medical Social Services
Medicare covers medical social work services when they’re medically necessary:
- Counseling and emotional support
- Resource connection and coordination
- Caregiver education and support
- Advance care planning assistance
- Community resource navigation
- Crisis intervention
Home Health Aide Services
Medicare covers home health aide services on a part-time or intermittent basis when they’re medically necessary and provided in conjunction with skilled care. Services include:
- Personal care assistance (bathing, grooming)
- Help with activities of daily living
- Light housekeeping related to medical care
- Meal preparation for special diets
- Companionship during skilled care visits
Medical Supplies and Equipment (DME)
Medicare may cover certain medical supplies and durable medical equipment needed for your home health care, such as:
- Wound care supplies
- Diabetes testing supplies
- Ostomy supplies
- Wheelchairs, walkers, or canes
- Hospital beds
Understanding Medicare Costs
One of the most confusing aspects of Medicare is understanding what you’ll pay. Here’s a breakdown:
Medicare Part A Coverage
If you’re eligible for Medicare Part A (usually after a qualifying hospital stay of at least 3 days), you may receive up to 100 days of home health care with no cost for the first 20 days. Days 21-100 require a daily coinsurance.
Medicare Part B Coverage
For most home health services covered under Medicare Part B:
- Deductible: You must first meet your annual Part B deductible ($240 in 2026)
- Coinsurance: After meeting your deductible, Medicare typically pays 80% of the Medicare-approved amount
- Your Responsibility: You pay the remaining 20% coinsurance
What This Means in Practice
For a typical course of physical therapy: (numbers expressed below are for a simplified example only as visit rates vary)
- Medicare approves $100 per visit
- Medicare pays $80 (80%)
- You pay $20 (20%)
However, if you have supplemental insurance (Medicare Advantage or Medigap), your out-of-pocket costs may be lower or eliminated.
Chicago-Specific Medicare Resources
As a Chicago senior, you have access to local resources to help you understand and access your Medicare benefits:
Illinois Senior Health Insurance Program (SHIP)
SHIP provides free, unbiased counseling about Medicare benefits:
- Phone: 1-800-252-8966
- Website: illinois.gov/aging/ship
- Services: Help understanding Medicare options, comparing plans, resolving billing issues
Chicago Area Medicare Resources
- Chicago Department of Family and Support Services: Senior Services Division
- Cook County Sheriff’s Office: Senior Services
- Local Area Agencies on Aging: Provide information and assistance
Finding Medicare-Certified Agencies
To find Medicare-certified home health agencies in Chicago:
- Visit Medicare.gov’s Home Health Compare tool
- Call 1-800-MEDICARE (1-800-633-4227)
- Ask your doctor or hospital discharge planner for recommendations
At HomeHealth, Inc., we’re proud to be a Medicare-certified agency serving Chicago and 10 surrounding counties.
How to Get Started with Medicare Home Health Care
Getting started with Medicare home health care is straightforward when you know the process:
Step 1: Talk to Your Doctor
The first step is discussing your needs with your physician. Ask:
- “Do I qualify for home health care?”
- “Can you write an order for home health services?” (also known as Face-To-Face/F2F)
- “What services do I need?”
Your doctor will assess your condition and determine if home health care is medically appropriate.
Step 2: Choose a Medicare-Certified Agency
You have the right to choose any Medicare-certified home health agency. When choosing, consider:
- Certification: Is the agency Medicare-certified?
- Experience: Do they have experience with your specific needs?
- Location: Do they serve your area?
- Reputation: What do other patients say?
- Services: Do they offer the services you need?
At HomeHealth, Inc., we’re Medicare-certified and have extensive experience serving Chicago seniors.
Step 3: Agency Contacts Your Doctor
Once you choose an agency, they will contact your doctor to:
- Review your medical needs
- Confirm the physician’s order
- Develop a plan of care
- Coordinate your first visit
Step 4: Begin Care
Your first home health visit will include:
- Assessment of your needs and home environment
- Review of your plan of care
- Introduction to your care team
- Scheduling of future visits
Common Medicare Home Health Misconceptions
Let’s clear up some common misunderstandings:
Misconception #1: “Medicare Pays for Everything”
Reality: Medicare covers medically necessary skilled services provided by Medicare-certified agencies. It doesn’t cover custodial care (help with bathing, dressing, meals) unless it’s part of your skilled care plan.
Misconception #2: “I Can Choose Any Home Health Agency”
Reality: You can choose any Medicare-certified agency, but non-certified agencies won’t be covered by Medicare. Always verify certification before choosing.
Misconception #3: “Home Health Care Is Only for Seniors”
Reality: Medicare covers home health care based on medical need, not age. Younger people with qualifying conditions (such as after surgery or injury) can also receive Medicare-covered home health care.
Misconception #4: “I Must Be Hospitalized First”
Reality: While many people start home health care after a hospital stay, it’s not always required. If your doctor determines you need skilled care at home, you may qualify without a recent hospitalization.
Misconception #5: “Home Health Care Is the Same as Assisted Living”
Reality: Home health care provides skilled medical services intermittently. Assisted living provides housing and custodial care 24/7. They’re different services with different coverage rules.
Supplemental Insurance Options
Many Chicago seniors have supplemental insurance to help cover Medicare costs:
Medicare Advantage Plans
Medicare Advantage (Part C) plans are offered by private insurance companies and provide all Part A and Part B coverage, often with additional benefits. Some plans may offer:
- Lower coinsurance
- Additional home health visits
- Transportation services
- Wellness programs
Medigap (Medicare Supplement) Policies
Medigap policies help pay Medicare costs you’d otherwise pay, such as:
- Coinsurance (20%)
- Deductibles
- Copayments
Illinois-Specific Options
Illinois residents have access to various Medicare Advantage and Medigap plans. The Illinois Department of Insurance can help you compare options.
What to Expect During Your First Home Health Visit
Your first visit with At HomeHealth, Inc. will include:
Initial Assessment
Our team will:
- Review your medical history and current condition
- Assess your home environment for safety
- Evaluate your mobility and functional abilities
- Discuss your goals and preferences
Care Plan Review
We’ll explain:
- What services you’ll receive
- How often visits will occur
- Who will be providing your care
- What you can do between visits to support your recovery
Setting Expectations
We’ll discuss:
- Timeline for improvement
- Warning signs to watch for
- When to call us or your doctor
- How to reach us with questions
Tips for Maximizing Your Medicare Home Health Benefits
1: Be Proactive
Don’t wait until you’re in crisis. If you notice changes in your health or mobility, talk to your doctor about home health care early.
2. Understand Your Coverage
Review your Medicare plan annually. Understand what’s covered and what your out-of-pocket costs might be.
3. Choose the Right Agency
Select a Medicare-certified agency with experience in your specific needs. At HomeHealth, Inc., we specialize in serving Chicago seniors.
4. Participate in Your Care
Home health care is most effective when you’re an active participant. Follow your care plan, do your exercises, and communicate with your care team.
5. Ask Questions
If you’re unsure about anything—coverage, costs, services—ask! We’re here to help you understand your benefits.
When to Consider Home Health Care
Consider home health care if you or a loved one:
- Recently returned home from the hospital
- Had surgery and need rehabilitation
- Experienced a decline in mobility or function
- Have a new or worsening chronic condition
- Need help managing medications
- Are recovering from a stroke or heart attack
- Have difficulty with daily activities
- Need wound care or other skilled nursing services
Contact At HomeHealth, Inc. Today
If you’re a Chicago senior considering home health care, we’re here to help. As a Medicare-certified agency, we understand the benefits you’re entitled to and can help you access them.
Our Commitment to Chicago Seniors
- We’re fully Medicare-certified
- We serve Chicago and 10 surrounding counties
- We coordinate with your physician
- We provide compassionate, respectful care
- We understand Medicare billing and coverage
Get Started Today
Phone: 773-279-9244 Fax: 773-279-9255
Email: info@ahhchicago.com
Service Area: Chicago and 10 Illinois Counties
Remember, a physician’s order is required to begin services, but that doesn’t mean you have to navigate the process alone. Our team is here to help you understand your Medicare benefits and get the care you need.
This article provides general information about Medicare home health benefits as of May 2026. For specific questions about your coverage, please contact Medicare directly at 1-800-MEDICARE or consult with a licensed insurance professional.