Choosing a home health agency is one of the most important decisions you can make for yourself or someone you love. The right agency can make it possible to recover from illness, manage a chronic condition, or maintain independence — all from the comfort of home. This guide is here to help you ask the right questions and feel confident in your choice for care.
About Home Health
Home health is a type of skilled medical care delivered in a patient’s home by a licensed clinician. It is typically ordered by a physician and carried out by licensed professionals who visit on a scheduled basis. Your team may include registered nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers.
Home health is different from home care, which is non-medical in nature and focuses on assistance with daily activities like meal preparation, medication reminders, transportation and errands, and personal care support. Home health is specifically medical in nature. To learn more about the differences between home health and home care, view the chart on our Types of In-Home Caregivers and Care Services page.
Home health may include:
- Wound care and medication management
- Monitoring of chronic conditions like heart failure, diabetes, or COPD and preventing or slowing deterioration in the patient’s condition
- Post-surgical or post-hospitalization recovery
- Rehabilitation after a stroke, fall, or orthopedic procedure
- Patient and family education about managing a health condition at home
Home health services are covered by Medicare, Medicaid, and many private insurance plans when specific eligibility criteria are met, such as the need for skilled care (skilled nursing or therapy services), being considered “confined to the home” or “homebound,” and being under the care of a physician who certifies that the services are medically necessary.
Being considered “confined to the home” or “homebound” does not mean that you or your loved one can never leave home. Rather, the individual receiving home health must require assistance to leave the home, and leaving home requires considerable and taxing effort. Absences from home that are infrequent and of relatively short duration are permitted, including attending medical appointments, religious services, and adult day care.
Questions to Ask About Home Health Services
Not all home health agencies are the same. Before choosing one, it is worth asking detailed questions about how they operate and what they can offer.
About the agency:
- Is the agency Medicare-certified and state-licensed?
- How long has the agency been operating?
- What is the agency’s quality rating on Medicare’s Care Compare tool?
- Is the agency accredited by an independent organization, such as The Joint Commission, ACHC, or CHAP?
About your care:
- What specific services does the agency provide, and do they match what my physician has ordered?
- Who will be assigned to my care, and will I see the same clinicians consistently?
- What is the process if my regular clinician is unavailable?
- How does the agency communicate with my physician and other members of my care team?
- How does someone qualify for home health aide services, and what scope of services does the agency provide?
About logistics:
- What are the agency’s hours of operation? Is someone available by phone after hours?
- How quickly can care begin after a referral is received?
- What happens if my needs change during the course of care?
- How does the agency handle emergencies?
About costs:
- Does the agency accept my insurance, including Medicare or Medicaid?
- What, if anything, will I be responsible for paying out of pocket?
- Will I receive a written notice of my rights and expected costs before care begins?
You have every right to ask these questions before committing to an agency. A good agency will welcome them.
Common Home Health Care Misconceptions
There are several widely held beliefs about home health that can lead people to delay care or choose the wrong service for their needs.
“Home health care means I’m no longer independent.” Home health is for anyone who needs skilled medical care at home, including people recovering from surgery, managing a new diagnosis, or working to regain strength after a hospitalization. Many home health patients go on to regain full independence. However, the goal of home health isn’t always improvement, it can be to prevent or slow deterioration so that you or your loved one can remain at home.
“I can only use the agency my hospital or physician recommends.” Your hospital or physician may suggest an agency, and that referral can be a helpful starting point. But you have the right to choose your own home health agency. Take the time to compare your options.
“I can’t afford home health care.” Home health is covered by Medicare, Medicaid, and most private insurance companies when specific conditions are met. Eligibility criteria are specific to your payor. It is important to note that coverage is not unlimited, and not all services that occur in the home are covered under the home health benefit.
“All home health agencies are basically the same.” Agencies vary significantly in quality, staffing, responsiveness, and the range of services they offer. Checking quality ratings and asking detailed questions can make a real difference in the care you receive.
“Home health is only for older adults.” People of all ages use home health services. Children and working-age adults recovering from illness, injury, or surgery may all be eligible for home health care.
“I don’t qualify for home health because I’m not homebound.” While it is true that to qualify for home health services under Medicare, you must be under the care of a doctor, considered “homebound,” and require part-time or intermittent skilled nursing care or therapy, homebound does not mean that you are unable to leave home altogether, but rather that you require assistance and/or it’s a significant and taxing effort. Other payors may have different eligibility requirements.
“Home health only includes nursing services.” Home health care includes nursing, physical/occupational/speech therapy, and aide services and medical social services where appropriate for your care.
“Home health care is only for a short period of time.” Home health care can continue to be provided so long as you continue to meet eligibility requirements, and your physician reevaluates and re-certifies your plan of care.
What to Look Out for When Choosing a Home Health Provider
While the majority of home health providers are committed to safe, high-quality care, it is important to be an informed consumer.
Be cautious if an agency:
- Is unable or unwilling to provide their Medicare certification number or state license information.
- Pressures you to accept services before you have had a chance to review your options
- Cannot clearly explain what your insurance will cover and what costs you may be responsible for
- Provides caregivers whose credentials you cannot verify
- Requests you to sign an incomplete or blank document
- Does not provide a copy of your written plan of care or fails to communicate with your physician
- Does not work to collaborate with your attending physician or other care providers
- Is unwilling to facilitate collaboration with your choice of provider
Know your rights
Under Medicare, home health patients have specific rights, including the right to be informed about their care, to participate in planning that care, to choose their home health provider, and to be treated with dignity and respect. Ask for a copy of your Home Health Patient Bill of Rights when you begin services. Learn more about your rights in our Your Rights section.
Watch for signs of poor quality during care
Missed visits, inconsistent communication, staff who seem unfamiliar with your care plan, or a lack of follow-through on changes in your condition are all worth raising with the agency — or with your physician.
If something doesn’t feel right, trust your instincts and do not hesitate to ask questions or seek a different provider.
How to Find a Home Health Provider
There are several reliable ways to find and evaluate home health agencies in your area.
- The Alliance’s Find a Provider Tool: The National Alliance for Care at Home maintains a provider search tool that can help you locate home health agencies in your community.
- Medicare’s Care Compare: The Centers for Medicare & Medicaid Services (CMS) maintains Care Compare at Medicare.gov, a free tool that allows you to search for Medicare-certified home health agencies by location and compare their quality ratings. Ratings are based on patient outcomes, patient experience, and timely initiation of care, among other factors.
- Your Care Team & Network: Your physician, hospital discharge planner, or social worker can be a valuable resource. They work with agencies regularly and can often speak to the quality and responsiveness of local providers. You can also ask trusted friends or members of your community who may have experience with home health if they recommend an agency. Remember, the final choice is yours.
- Accrediting Organizations: Agencies accredited by organizations such as CHAP (Community Health Accreditation Partner), ACHC, or The Joint Commission have met independent quality standards beyond what is required for Medicare certification. Accreditation is a meaningful signal of an agency’s commitment to quality.
For more detailed information on finding any type of in-home care, view the comparison chart on our Finding a Carer page.
CaringInfo is a program of the National Alliance for Care at Home. Our goal is that all people make informed decisions about their care. This content is for educational purposes and is not a substitute for advice from your physician or care team.
