Northland home health

eligibility

Who qualifies for home care?

Requirements for receiving home health care depend on your need and payer source. Anyone recovering from acute illness or surgery, or managing any chronic medical, physical, mental, or behavioral condition or disability that hinders the ability to function and care for oneself could qualify to receive home health care. There are different types of home care services, meaning that people may qualify to receive skilled nursing, rehabilitation therapy and/or assistive and supportive services. Additional eligibility requirements apply depending on your payer source, such as private pay, Elderly Waiver, HMO, Medicaid, or Medicare.

Do I qualify for supportive services?

These are non-medical support service provided to anyone, who because of advanced age or physical or mental infirmity, cannot care for his/her needs. Such services may include assistance with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and bathing, or household tasks related to the care of the aged or homebound person, such as cleaning, meal preparation, bed making, laundry, and other similar services.

How do I find out if I qualify for homecare services?

Who or where you call depends on the kind of insurance or medical assistance you receive:

  • Call your health insurance number at the back of your card and ask if your plan qualifies you to receive homecare services 
  • If so, ask about the specific types of home-care services that you can receive under your plan (skilled nursing, personal care assistance (PCA), home health aide (HHA), homemaking (HMK), respite, home care nursing (formerly private duty nursing), physical therapy, etc)

Call (651) 431-2700, or for TTY users call (800) 627-3529, to see if you are eligible to apply for Medicaid (MA). Minnesota Department of Human Services’ detailed descriptions about eligibility.

 

If you have Medicaid or any type of a waiver service, then you are already assigned to a caseworker* through your county. To begin, call your caseworker to determine your eligibility for home-care services. Then your caseworker will call a public health nurse to assess your needs for personal care assistance, homemaking, skilled nursing, etc. within 30 days. Based on the assessment, the county authorizes the number of hours per service type that you will receive.

 

Types of Home and Community-Based (Waivers) Services include:

  • Alternative Care (AC) Waiver
  • Developmental Disability (DD) Waiver
  • Community Access for Disability Inclusion (CADI) Waiver  
  • Community Alternative Care (CAC) Waiver
  • Elderly Waiver (EW)
  • Traumatic brain injury (TBI) Waiver

 

Income Eligibility/Asset Limits:  

  • You may be MA-eligible if your monthly income is less than income limits shown below.  
  • Contact your county to help you determine your income and asset limits
  • Income and spend-down limits change every year according to federal/state guidelines.
  • For more information about income limits, visit MN Department of Human Services  or MN Department of Human Services.

 

General Medical Assistance (GM) or Medicaid (also known as straight MA): people with MA do not have case workers. Apply at MN Department of Human Services.

To qualify for home care with Medicare as payer source:

  1. The client must be 65 and older or a person with a certified disability.
  2. The client needs to be homebound: A patient is homebound if leaving the home requires considerable and taxing effort. The patient may leave the home for short periods primarily for medical purposes.
  3. The care provided must be medically necessary: An acute diagnosis, exacerbation of a medical condition, recent hospitalization, and acute related problems that require intervention.
  4. The client requires the skill level of one of the qualifying nurses, such as skilled nursing, for continued care.
  5. The services provided must be on an intermittent basis and individualized to the patient.
  6. The service provided may include certified home health aides as necessary.

Private Pay, HMO, or VA Insurance Holders +

Call your health insurance number at the back of your card and ask if your plan qualifies you to receive homecare services If so, ask about the specific types of home-care services that you can receive under your plan (skilled nursing, personal care assistance (PCA), home health aide (HHA), homemaking (HMK), respite, home care nursing (formerly private duty nursing), physical therapy, etc)

Medicaid/Waiver Holders +

Call (651) 431-2700, or for TTY users call (800) 627-3529, to see if you are eligible to apply for Medicaid (MA). Minnesota Department of Human Services' detailed descriptions about eligibility. If you have Medicaid or any type of a waiver service, then you are already assigned to a caseworker* through your county. To begin, call your caseworker to determine your eligibility for home-care services. Then your caseworker will call a public health nurse to assess your needs for personal care assistance, homemaking, skilled nursing, etc. within 30 days. Based on the assessment, the county authorizes the number of hours per service type that you will receive. Types of Home and Community-Based (Waivers) Services include: Alternative Care (AC) Waiver Developmental Disability (DD) Waiver Community Access for Disability Inclusion (CADI) Waiver Community Alternative Care (CAC) Waiver Elderly Waiver (EW) Traumatic brain injury (TBI) Waiver Income Eligibility/Asset Limits: You may be MA-eligible if your monthly income is less than income limits shown below. Contact your county to help you determine your income and asset limits Income and spend-down limits change every year according to federal/state guidelines. For more information about income limits, visit MN Department of Human Services or MN Department of Human Services. * General Medical Assistance (GM) or Medicaid (also known as straight MA): people with MA do not have case workers. Apply at MN Department of Human Services.

Medicare Coverage +

To qualify for home care with Medicare as payer source: The client must be 65 and older or a person with a certified disability. The client needs to be homebound: A patient is homebound if leaving the home requires considerable and taxing effort. The patient may leave the home for short periods primarily for medical purposes. The care provided must be medically necessary: An acute diagnosis, exacerbation of a medical condition, recent hospitalization, and acute related problems that require intervention. The client requires the skill level of one of the qualifying nurses, such as skilled nursing, for continued care. The services provided must be on an intermittent basis and individualized to the patient. The service provided may include certified home health aides as necessary.

Does my insurance cover the cost of home health-care service?

The agency accepts most private insurance and HMOs as long as the physician has approved the need for home health-care services. Additionally, we accept Medicare and Medicaid for payment. Please email or call for specific insurance information.

What happens once I qualify to receive home care?

Once approved for services, have the caseworker refer your case to a home-care provider agency of your choosing, like Northland Home Health Network. Northland will send a registered nurse to process your admission and design a plan of care based on the initial assessment and information from your physician.

Once admitted, Northland Home Health may assign you an employee or you may bring your own employee who may be a family member, neighbor, or friend as your personal care assistant, homemaker, home health aide, or nurse, depending on your authorized service(s).