Understanding Medicare-Covered Home Care Services in Minnesota

At TRU Healthcare, we believe that every Minnesotan who needs home care should be able to receive compassionate, professional support in the comfort of their own home. However, we also understand that navigating the details of Medicare and Medicare Advantage-covered home care services can be confusing for many individuals and families.

Our goal is to help you better understand your Medicare and Medicare Advantage benefits — including which home care services are covered, who qualifies for coverage, and how to access the care you need. By providing clear, accurate information, TRU Healthcare aims to empower you to make informed decisions about your health and well-being.

While our primary focus for this blog is on serving as a Medicare-approved provider for home care services, TRU Healthcare also accepts many other insurance plans to ensure more individuals can access the quality care they deserve. No matter your coverage, our team is dedicated to helping you navigate your options and receive the support that fits your needs.

Whether you’re exploring home care options for yourself or a loved one, we’re here to offer guidance, clarity, and trusted support every step of the way.

Medicare Benefits Explained

Medicare is a federal health insurance program in the United States that primarily serves people aged 65 and older, as well as certain younger individuals with disabilities or specific medical conditions (like End-Stage Renal Disease).

It’s divided into four main parts:

• Part A (Hospital Insurance): Covers inpatient hospital care, skilled nursing facilities, hospice, and some home health care.
• Part B (Medical Insurance): Covers outpatient care, doctor visits, preventive services, and medical supplies.
• Part C (Medicare Advantage): Offered by private companies approved by Medicare; combines Parts A and B and often includes prescription drug coverage and extra benefits. Part C also covers some home health care.
• Part D (Prescription Drug Coverage): Helps cover the cost of prescription medications.

Medicare helps reduce healthcare costs for seniors and eligible individuals, though it usually doesn’t cover all expenses, so many people also purchase supplemental insurance (Medigap) to help pay remaining costs.

For home care services you can use either straight Medicare (Medicare A) or a Medicare Advantage plan (Medicare C).

 

What Home Health Services Are Covered?

Before exploring the details of Medicare coverage, it’s important to understand what home health services mean and when they may be an option.

Under Medicare and Medicare Advantage plans, home health care may be covered when specific conditions are met. Typically, individuals qualify if they have experienced a physical or mental change in their condition that makes it difficult or unsafe to leave home or perform daily activities as they once did.

This change in condition may result from situations such as:

• Recovery after a hospital stay, fall, or injury
• A recent surgery requiring follow-up care
• A noticeable decline in physical or cognitive health observed by family members
• Frequent falls or increased safety concerns in the home

To receive coverage, Medicare requires that the individual be considered “homebound.” This means leaving the home is either medically inadvisable or requires considerable effort and assistance, making it taxing or unsafe to do so.

Understanding this homebound requirement is essential, as Medicare will only cover home health services when this condition is met.

Medicare and Home Health: What Is Covered?

Medicare Part A and most Medicare Advantage plans provide coverage for eligible home health services, helping individuals receive skilled care in the comfort of their own homes.

Below are the primary types of home health services that may be covered under Medicare:

 

Skilled Nursing

Skilled nursing care is a key component of home health services covered by Medicare. These services must be provided under the supervision of a Registered Nurse (RN), with a Licensed Practical Nurse (LPN) assisting in carrying out the prescribed plan of care.

In a home care setting, skilled nursing focuses on helping patients manage medical needs safely and effectively at home. This level of care may include:

• Complex wound care and dressing changes
• Education for patients and caregivers
• Ongoing assessment and monitoring

Skilled nursing provides essential clinical support, helping individuals maintain their health, avoid unnecessary hospital visits, and achieve greater comfort and independence at home.

Physical Therapy

Physical therapy plays a vital role in helping individuals regain independence and improve their quality of life while receiving home care services. A licensed Physical Therapist (PT) will evaluate each patient’s needs and develop a personalized, goal-oriented plan of care. A Physical Therapist Assistant (PTA) may then assist in carrying out the prescribed treatment plan under the supervision of the PT.

Physical therapy in home care focuses on helping patients restore and maintain physical function, safety, and mobility through:

• Strength and endurance training
• Improving balance and coordination
• Mobility, gait, and transfer training
• Fall prevention education
• Safe use of walkers and assistive devices
• Pain management techniques and posture improvement

Through consistent therapy and encouragement, physical therapy supports recovery, promotes independence, and helps individuals move safely and confidently within their own homes.

Occupational Therapy

Occupational therapy (OT) helps individuals regain the ability to perform daily living activities safely and independently in their home environment. A licensed Occupational Therapist (OT) develops a personalized plan of care tailored to each patient’s unique needs and goals, while a Certified Occupational Therapy Assistant (COTA) may support the implementation of this plan under the OT’s supervision.

Home-based occupational therapy focuses on:

• Improving the ability to perform everyday tasks
• Enhancing fine motor skills and coordination
• Modifying the home environment
• Providing adaptive equipment and training
• Energy conservation and fatigue management
• Cognitive testing and education if needed

By targeting practical, real-world skills, occupational therapy helps patients maintain independence, prevent injuries, and continue living safely and comfortably at home.

 

Speech Therapy

Speech therapy, also known as speech-language pathology, is designed to help individuals with communication, speech, and swallowing difficulties resulting from illness, injury, or neurological conditions. A licensed Speech-Language Pathologist (SLP) evaluates each patient’s needs and develops a personalized plan of care.

In the home setting, speech therapy may focus on:

• Improving speech clarity and communication skills
• Enhancing language comprehension and expression
• Swallowing and swallowing safety (dysphagia management)
• Cognitive-communication support
• Caregiver training and strategies

Speech therapy helps patients regain independence in communication, promotes safe eating and swallowing, and supports overall quality of life within the comfort of their home.

Medical Social Services

Medical social services are an important component of home health care, providing emotional, social, and practical support for patients and their families. A licensed Medical Social Worker (MSW) works with patients to address the challenges that often accompany illness, injury, or recovery at home.

Services provided by medical social workers may include:

• Emotional and mental health support
• Assistance navigating the healthcare system
• Access to community resources
• Care planning and advocacy

By addressing the emotional, social, and practical aspects of home health care, medical social workers help patients and families feel supported, empowered, and better able to manage life at home during recovery or ongoing care.

 

Home Health Aides (HHAs)

Home Health Aides provide personal care and support to individuals receiving home health services, helping them maintain daily routines safely and comfortably. Home health aide services are provided under the supervision of a skilled nurse or therapist, ensuring that personal care aligns with the patient’s overall plan of care. It’s important to note that Home Health Aide (HHA) services cannot be provided as a standalone service. They must be accompanied by another skilled discipline, such as Skilled Nursing (SN), Occupational Therapy (OT), Physical Therapy (PT), or Speech Therapy (ST).

Home Health Aides can assist with:

• Personal hygiene and grooming
• Mobility support
• Light meal preparation and nutrition support
• Monitoring and reporting changes in health status
• Assistance with daily routines

While HHAs do not provide skilled medical care, their support is essential in helping patients live safely at home, maintain dignity, and achieve a higher quality of life during recovery or ongoing care.

Who Is Eligible for Medicare Home Health Coverage?

To qualify for Medicare-covered home health services, individuals must meet specific requirements. Eligibility is based on medical necessity, homebound status, and proper documentation from a licensed healthcare provider.

Key Criteria for Eligibility:

1. Referral from a Licensed Provider
   • A referral must come from a licensed healthcare provider.
   • The provider must oversee and follow the patient’s entire plan of care, including ordering services, tracking progress toward goals, and managing discharge.
2. Face-to-Face Encounter
   • The patient must have a face-to-face visit with their provider, who documents why home care is medically necessary and confirms that the patient meets homebound criteria.
3. Homebound Status
   Medicare defines homebound as a condition where leaving home requires considerable and taxing effort, or is medically unsafe without assistance. Homebound status can include the need for a mobility device (walker, cane, wheelchair) or help from another person along with meeting other specific limitations:

Indicators of homebound status may include:

1. • High risk for falls
   • Limited ambulation
   • Needs assistance for most or all daily activities
   • Bedbound or largely confined to home
   • Cannot safely leave home unassisted
   • Injury, trauma, or decreased ability to walk without support

Specific medical or functional limitations may include:

1. • Pain with mobility
   • Moderate to severe shortness of breath (dyspnea)
   • Residual weakness from illness, surgery, or injury
   • Medical restrictions (e.g., weight-bearing limits, arrhythmias)
   • Confusion, disorientation, or inability to leave home safely alone

By carefully documenting these factors, providers help ensure that home health services are covered by Medicare and tailored to meet the patient’s needs safely and effectively.

 

Accessing Home Health Services in Minnesota

Starting home health care is a straightforward process, whether you are leaving the hospital or arranging care from home. Here’s a step-by-step guide:

1. If You Are Hospitalized

• Hospital staff, such as a hospitalist or medical social worker (MSW), will ask which home health agency you prefer.
• If you are unsure, hospitals typically provide a list of Medicare-certified agencies to choose from.
• Once you select an agency, the hospital can send a referral and doctor’s orders to start home health services.

2. If You Are Not Hospitalized

• Discuss your needs with your healthcare provider.
• Your provider can determine whether home health care is appropriate and send a referral along with a plan of care to the home health agency of your choice.

3. Choosing a Home Health Agency

• You have the right to choose the home health agency that provides your care.
• Your provider may recommend an agency, or a hospital discharge planner may provide a list.
• At TRU Healthcare, we pride ourselves on providing compassionate, professional care and hope you will consider us for your home health needs.

By understanding these steps, you can confidently access home health care and ensure that services start smoothly and efficiently.

The First Home Health Visit

Once your chosen home health agency receives your referral, a clinician will schedule an initial visit to your home. During this visit, the clinician will:

• Conduct a thorough assessment of your medical condition, functional abilities, and home environment
• Review your medications and any current treatment plans
• Develop or confirm your individualized plan of care, including therapy goals, nursing needs, and frequency of visits
• Provide education and guidance for you and your caregivers on managing your condition safely at home
• Identify any safety concerns in the home, such as fall risks, mobility challenges, or the need for adaptive equipment

This first visit sets the foundation for your care, ensuring that all services are personalized, coordinated, and aligned with your Medicare-covered plan of care. It’s also an opportunity to ask questions and discuss any concerns about your care.

Special Considerations for Minnesotans

While Medicare is a federal program, living in Minnesota gives you access to a strong network of high-quality healthcare providers. At TRU Healthcare, we are proud to be deeply rooted in the communities we serve and understand the unique needs of patients across the state.

Our clinicians are knowledgeable about local resources and can help you connect with additional support systems, whether it’s transportation services, community programs, or specialized care options.

We are committed to providing care that respects your values, lifestyle, and home environment, whether you live in a bustling city or a quiet rural area. By combining professional expertise with local insight, we ensure that your home health care is both personalized and accessible.

Your Partner in Health at Home

Navigating Medicare and arranging home health care can feel overwhelming, but you don’t have to do it alone. At TRU Healthcare, we provide not only skilled medical services but also the compassion, guidance, and support you deserve.

We are committed to empowering you with knowledge, helping you make informed decisions about your care, and ensuring that every step of the process is clear and manageable.

If you or a loved one could benefit from home health care, start the conversation with your provider. When you’re ready, TRU Healthcare will be here to welcome you, providing professional, personalized care in the comfort of your own home.

Commonly Asked Questions About Medicare-Covered Home Health Care

At TRU Healthcare, we know that understanding Medicare’s home care benefits can be confusing, especially when it comes to what’s covered, how long services last, and who determines your care plan. Below are answers to some of the most common questions we receive from patients and families.

 

Is skilled home care coverage long-term under Medicare?

No, Medicare’s skilled home care coverage is not long-term. Medicare covers intermittent or short-term skilled care that is medically necessary and ordered by your doctor. This typically includes services such as skilled nursing, physical therapy, occupational therapy, or speech therapy provided in your home for a limited period.

Once your condition improves or you no longer require skilled care on a part-time or intermittent basis, Medicare coverage for home health services will end. For ongoing, non-medical, or custodial care needs, other options such as private pay, long-term care insurance, or Medicaid may be available.

 

In skilled home healthcare, who decides how many visits I will receive?

The number of home health visits you receive is determined by your doctor and your home health care team. Your physician will evaluate your condition and create a personalized plan of care that outlines the type and frequency of services you need. The home health agency — such as TRU Healthcare — then provides care according to this plan and regularly communicates with your doctor to track your progress and make any necessary adjustments.

This ensures that you receive the appropriate level of skilled care based on your medical needs and Medicare’s coverage guidelines.

 

Our Commitment to Your Care

At TRU Healthcare, we work closely with your physician to ensure you receive the right amount of care, at the right time, in the comfort of your own home. While we proudly specialize in Medicare-covered home care services, we also accept many other insurance plans to make quality home health care accessible to more Minnesotans.

Our team is here to provide guidance, clarity, and compassionate support — every step of the way.